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Review
Metastatic disease from uveal melanoma: treatment options and future prospects
  1. Richard D Carvajal1,
  2. Gary K Schwartz1,
  3. Tongalp Tezel2,
  4. Brian Marr3,
  5. Jasmine H Francis3,
  6. Paul D Nathan4
  1. 1Division of Hematology/Oncology, Columbia University Medical Center, New York, USA
  2. 2Department of Ophthalmology, Columbia University Medical Center, New York, USA
  3. 3Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
  4. 4Division of Cancer Services, Mt Vernon Cancer Centre, Northwood, UK 
  1. Correspondence to Dr Richard D Carvajal, Division of Hematology/Oncology, Columbia University Medical Center, New York, NY 10032, USA; rdc2150{at}cumc.columbia.edu

Abstract

Uveal melanoma represents ∼85% of all ocular melanomas and up to 50% of patients develop metastatic disease. Metastases are most frequently localised to the liver and, as few patients are candidates for potentially curative surgery, this is associated with a poor prognosis. There is currently little published evidence for the optimal management and treatment of metastatic uveal melanoma and the lack of effective therapies in this setting has led to the widespread use of systemic treatments for patients with cutaneous melanoma. Uveal and cutaneous melanomas are intrinsically different diseases and so dedicated management strategies and therapies for uveal melanoma are much needed. This review explores the biology of uveal melanoma and how this relates to ongoing trials of targeted therapies in the metastatic disease setting. In addition, we consider the options to optimise patient management and care.

  • Choroid
  • Ciliary body
  • Iris
  • Drugs
  • Treatment Medical

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bjophthalmol-2016-309034

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    Footnotes

    • Contributors Defining the concept: RDC. Drafting and critical revision: RDC, GKS, TT, BM, JHF and PDN.

    • Funding AstraZeneca.

    • Competing interests RDC received non-financial support from AstraZeneca, during the conduct of this work; RDC has received grants, personal fees and non-financial support from AstraZeneca, personal fees from Janssen, personal fees from Thompson Reuters, personal fees from Merck, personal fees from Biogen Idec, personal fees from Aura Biosciences, grants from Melanoma Research Foundation, grants from Melanoma Research Alliance, grants from NIH and grants from ASCO, outside the submitted work. PDN reports personal fees from AstraZeneca, outside the submitted work.

    • Provenance and peer review Not commissioned; externally peer reviewed.