Dzenana Detanac, Snezana Jancic, Milena Rakocevic, Merima Ceranic


Abstract: There has been significant progress made in the diagnosis and treatment of the primary uveal melanoma during the past decades and despite that, survival rate of uveal melanoma patients is still stable. Treatment options for uveal melanoma include phototherapy, brachytherapy, proton beam therapy, stereotactic radiotherapy, local resection, anti-angiogenic therapy, immunotherapy, and enucleation. Genetic analysis of tumors provides us with valuable prognostic information although effective therapies are lacking at this moment. It is not established yet whether prolonged survival is the result of treatment or whether it merely reflects earlier detection of metastases. Also, there are indications that survival after treatment of uveal melanoma probably does not depend on the method of treatment but rather on many clinical, histological and genetic risk factors. New studies are needed to provide a better understanding of of ocular treatment impact on survival in patients whose prognosis can be estimated according to the clinical stage, histological grade and genetic type. Therefore, the patients should be treated in experienced multi-disciplinary teams that must include these patients in clinical trial.

Keywords: uveal melanoma, therapy, immunotherapy, metastatic disease


uveal melanoma; therapy; immunotherapy; metastatic disease

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Virgili G, Gatta G, Ciccolallo L, et al. Incidence of uveal melanoma in Europe. Ophthalmology. 2007;114(12): 2309–15.

Shields CL, Ganguly A, Bianciotto CG, et al. Prognosis of uveal melanoma in 500 cases using genetic testing of fine-needle aspiration biopsy specimens. Ophthalmology. 2011; 118(2): 396–401.

Baurain JF, de Potter P. Practice guidelines in the management of uvel melanoma. Belg J Med Onco. 2013; 7: 20–6.

Woodman S. Metastatic uveal melanoma: biology and emerging treatments. Cancer J. 2012; 18(2): 148–52.

Singh AD, Topham A. Survival rates with uveal melanoma in the United States: 1973–1997. Ophthalmology. 2003; 110(5): 962–5.

Damato B. Progress in the management of patients with uveal melanoma. The 2012 Ashton Lecture. Eye. 2012; 26(9): 11157–72.

Lang GE, Mennel S, Spital G, et al. Different indications of photodynamic therapy in ophthalmology. Klin Monatsbl Augenheilkd. 2009; 226(9): 725–39.

Peer J. Ruthenium-106 Brachytherapy. In: Jager JM, Desjardins L, Kivela T, Damato BE, editors. Current concpets in Uveal Melanoma. Basel: Karger; 2012. p. 27–41.

Ruberol E, Roy P, Kodjiikian I, Gerard JP, Jean-Louis B, Grange JD. Survival, anatomic and functional long-term results in choroidal and ciliary body melanoma after ruthenium brachytherapy (15 years’ experinece with beta-rays). Am J Ophthalmol. 2004; 137(5): 893–900.

Bonnett DE, Kacperek A, Sheen MA, Goodall R, Saxton TE. The 62 MeV proton beam for the treatment of ocular melanoma at Clatterbridge. Br J Radiol. 1993; 66(790): 907–14.

Egger E, Zografos L, Schalenbourg A, Böhringer T, Chamot L, Goitein G. Eye retention after proton beam radiotherapy for uveal melanoma. Int J Radiat Oncol Biol Phys. 2003; 55(4), 867–80.

Modorati G, Miserocchi E, Galli L, Picozzi P, Rama P. Gamma knife radiosurgery for uveal melanoma: 12 years of experience. Br J Ophthalmol. 2009; 93(1): 40–4.

Fakiris AJ, Lo SS, Henderson MA, et al. Gamma-knife-based stereotactic radiosurgery for uveal melanoma. Stereotact. Funct. Neurosurg. 2007; 85(2–3), 106–12.

Muller K, Naus N, Nowak PJ, et al. Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results. Radiother Oncol. 2012; 102(2): 219–24.

Dunavoelgyi R, Dieckmann K, Gleiss A, et al. Local tumor control, visual acuity, and survival after hypofractionated stereotactic photon radiotherapy of choroidal melanoma in 212 patients treated between 1997 and 2007. Int J Radiat Oncol Biol Phys. 2011; 81(1), 199–205.

Gunduz K, Bechrakis NE. Exoresection and endoresection for uveal melanoma. Middle Eas Afr J Ophthalmol. 2010;17(3): 210–6.

Damato BE. Local resection of uveal melanoma. Dev Ophthalmol. 2012; 49: 66–80.

Puusaari I, Damato B, Kivelä T. Transscleral local resection versus iodine brachytherapy for uveal melanomas that are large because of tumour height. Graefes Arch Clin Exp Ophthalmol. 2007; 245(4): 522–33.

Bechrakis NE, Blatsios G, Schmid E, Petousis V, Willerding G, Foerster MH. Surgical resection techniques of large uveal melanomas. Spektrum Augenheilkd. 2010; 24:17–22.

Damato B, Lecuona K. Conservation of eyes with choroidal melanoma by a multimodality approach to treatment: an audit of 1632 patients. Ophthalmology 2004; 111(5): 977–83.

Wilson RS, Fraunfelder FT. ‘No-touch’ cryosurgical enucleation: a minimal trauma technique for eyes harboring intraocular malignancy. Ophthalmology. 1978; 85(11): 1170–5.

Houston SK, Ardila-Lonngi M, Markoe AM, Murray TG. Surgical management of posterior uveal melanoma. Expert Rev Ophthalmol. 2013; 8(4): 393–9.

El Filali M, Van der Velden PA, Jager MJ. Anti-angiogenic therapy in uveal melanoma. Dev Ophthalmol. 2012; 49:117–36.

Stitt AW, Gardiner TA. Anti-angiogenic therapy for uveal melanoma — more haste, less speed. Br J Ophthalmol. 2002; 86(4): 368–9.

Bosch JJ. Immunotherapy of uveal melanoma. Dev Ophthalmol. 2012; 49: 137–49.

Middleton MR, Corrie P, Sznol M, Infante J, Mulatero C, Evans J, Steven N, Krige D, Shingler WH, McGrath Y, Hassan Nj, Jakobsen BK. A phase I/IIa study of IMCgp100: Partial and complete durable responses with a novel first-in-class immunotherapy for advanced melanoma [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; 2015. Abstract nr CT106.

Singh AD, Shields CL, Shields JA. Prognostic factors in uveal melanoma. Melanoma Res 2001; 11(3): 255–63.

Sisley K, Rennie IG, Parsons MA, et al. Abnormalities of chro-mosomes 3 and 8 in posterior uveal melanoma correlate with prognosis. Genes Chromosomes Cancer. 1997; 19(1): 22–8.

Baurain JF, de Potter P. Practice guidelines in the management of uveal melanoma. Belg J Med Oncol. 2013; 7:20–6.

Mariani P, Piperno-Neumann S, Servois V, et al. Surgical management of liver metastases from uveal melanoma: 16 years’ experience at the Institut Curie. Eur J Surg Oncol. 2009; 35(11): 1192–7.

Feldman ED, Pingpank JF, Alexander HR Jr. Regional treatment options for patients with ocular melanoma metastatic to the liver. Ann Surg Oncol. 2004; 11(3): 290–7.

Leyvraz S, Piperno-Neumann S, Suciu S, et al. Hepatic intra-arterial versus intravenous fotemustine in patients with liver metastases from uveal melanoma (EORTC 18021): a multicentric randomized trial. Ann Oncol. 2014; 25(3): 742–6.

Van den Bosch T, van Beek JGM, Vaarwater J, et al. Higher percentage of FISH-determined monosomy 3 and 8q amplification in uveal melanoma cells relate to poor patient prognosis. Invest Ophthalmol Vis Sci. 2012; 53(6): 2668–74.



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