Uveal melanoma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D., Simrat Sarai, M.D. [2]

Overview

Pharmacologic medical therapy is recommended among patients with metastatic disease and include chemotherapy, immunotherapy, and targeted therapy.

Medical Therapy

Pharmacologic medical therapy is recommended among patients with metastatic disease:

• Chemotherapy
  • Dacarbazine
  • Temozolomide
  • Cisplatin
  • Treosulfan
  • Fotemustine
• Immunotherapy
  • Checkpoint blockade
    • Pembrolizumab
    • Ipilimumab + nivolumab
    • Ipilimumab + nivolumab
    • Ipilimumab + radioembolization
    • Ipilimumab + nivolumab +radioembolization
  • TILs (tumor-infiltrating lymphocytes)
  • T cell redirection
  • Antibody–drug conjugate
    • Glembatumumab vedotin
• Targeted therapy
  • PKC (protein kinase C)/ MEK
    • AEB071 + BYL719
    • Intermittent selumetinib
    • Selumetinib +/– paclitaxel
    • Binimetinib + AEB071
  • Multi-kinase inhibition
    • Sorafenib (STREAM)
    • Cabozantinib versus temozolomide/ dacarbazine
  • Epigenetic therapy
    • HDAC (histone deacetylase) inhibition
      • Vorinostat
      • Pembrolizumab + entinostat (PEMDAC)
    • BET (bromodomain and extra-terminal motif) inhibition
  • Liver-directed therapy
    • IHP (isolated hepatic perfusion)
    • PHP (percutaneous isolated hepatic perfusion) with melphalan