Uveal melanoma: In the era of new treatments

Uveal melanoma (UM), also known as choroidal melanoma, is the leading adult intraocular tumor worldwide, affecting mainly Caucasian populations.The last decade has seen an improvement in the outcome of these tumors at the localized stage, in favor of conservative treatment of the eye, notably with new radioactive treatment techniques. Despite optimal management, half of the patients will become metastatic, with liver involvement in 90% of cases. The prognosis is pejorative and considers clinical, tumor anatomy, histological and molecular parameters.This review provides a broad overview of the different therapeutic options for the management of localized or metastatic UM disease, with recently updated data. Despite the known limited efficacy of chemotherapy and immune checkpoint inhibitors (ICI), we discuss the first results of combined immunotherapies, the arrival of a new first-in-class immunomodulatory treatment Tebentafusp, in HLA-A*02:01 patients, avenues of research into targeted anti-tyrosine kinase therapies, and the growing use of ctDNA to guide treatment prescription.

Automated summary

Uveal melanoma is the leading intraocular tumor worldwide, predominantly affecting Caucasian populations. Recent advancements in conservative and radioactive treatments have improved outcomes for localized tumors. However, despite optimal management, half of the patients develop metastatic disease with liver involvement in 90% of cases. This review provides an overview of therapeutic options, including new immunomodulatory treatments and targeted therapies, for localized or metastatic UM disease.