Treating Uveal Melanoma

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By Sapna Patel, M.D., assistant professor, Department of Melanoma Medical Oncology

treatinguvealmelanoma.jpgWhen a patient is diagnosed with uveal melanoma, he or she should be evaluated by an ocular oncologist, an ophthalmologist who specializes in treating cancer of the eye.

The objective of this examination is to find out whether the uveal (or intraocular) cancer has spread to the optic nerve or nearby tissues of the eye socket, or has moved through the blood to other parts of the body.

Depends on diagnosis
When uveal melanoma is diagnosed, the treatment depends on whether the disease has metastasized to other organs. Most patients whose disease has not metastasized are treated with surgery known as enucleation or some form of radiation therapy.

A commonly used radiation treatment for uveal melanoma is plaque brachytherapy, in which a tiny radioactive disk is placed on the affected part of the eye for a few days, minimizing exposure to surrounding tissue.

Dan Gombos, M.D., associate professor and chief of the Section of Ophthalmology, is an ocular oncologist who specializes in the treatment of uveal melanoma, in addition to other intraocular malignancies. He works in coordination with Beth Beadle, M.D., and William Morrison, M.D., in the Department of Radiation Oncology, to manage these patients.

The latest diagnostic techniques and treatments for eye cancer are available at MD Anderson, where cutting-edge translational research is conducted, continually driving laboratory discoveries forward to application in the clinical realm.

Clinical trials for uveal melanoma patients
"Because of the multidisciplinary nature of the ophthalmologists, oncologists and research scientists at MD Anderson, we are actively designing research-driven clinical trials for patients with uveal melanoma," says Bita Esmaeli, M.D., professor in the Section of Ophthalmology.

"We have a prospective blood and tissue bank for uveal melanoma patients, which allows us to collect tissue and blood from thems, and provides the opportunity for us to offer personalized adjuvant treatments.

"With the recent advances in prognostic molecular markers for uveal melanoma, we're able to predict, with greater than 95% accuracy, who is going to get metastastic uveal melanoma at the time a patient is diagnosed with an eye tumor.

"Armed with that information, we can offer adjuvant trials as an early intervention and hopefully before the tumor metastasizes. One of the priorities is to offer drugs based on the genetic signature of the tumor." 

Esmaeli is the uveal melanoma tissue and blood bank principal investigator. The facility has housed tissue and blood samples from patients with uveal melanoma since 2003.

Agop Bedikian, M.D., professor and deputy director of the Skin Center in the Department of Melanoma Medical Oncology, and I have been key players in designing adjuvant trials for uveal melanoma patients at MD Anderson. An adjuvant treatment is a therapy added to reduce the risk of metastasis after the local treatment for the eye melanoma is completed.

Bedikian, who has been with MD Anderson for more than three decades, is globally renowned as a pioneer in the investigation and use of novel treatments for patients with melanoma.

Through the years, he has created a comprehensive clinical database on uveal melanoma, containing the clinical outcomes of the different treatments and drugs that he has tested in trials for these patients.

Information on our melanoma treatments and melanoma clinical trials is available online and by calling 1-713-792-3245 or (toll free) 1-877-632-6789.

Related story
Uveal Melanoma: What is it?

Photo courtesy of Bita Esmaeli, M.D.

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