Ocular melanoma or OM metastasis is something no one wants to hear, but yet, here we are. You may have just been given the news that your ocular melanoma has spread or that your current treatment plan might not be working. A Cure In Sight is here to help you. We have a compassionate team of ocular melanoma patients to help you find your way. Maybe you would like a buddy who has gone through the same treatment, a support group or just general information …you can find it here.
If you are looking for someone to help you through your journey, please see our Resources Tab for our buddy program Cure Companions, physician finder and resources to find support groups.
Working with your physician (a Medical Oncologist who specializes in metastatic OM) to find the right plan for you is essential. Your doctor can explain the options available to you. They can guide you on clinical trials that might be the right fit for you. You can also use our convenient clinical trial finders to research the latest trials. Most importantly, there is every reason to have hope, as there are finally multiple cancer therapies now in active development and clinical trials for metastatic OM.
Uveal melanoma metastasis typically spreads to the liver first, but there have been patients who have had initial metastasis in other organs. Lung, bone, skin, soft tissue and lymph nodes are also areas that can be affected.
As you discuss treatment plans with your physician, you should be aware that there are still no therapies specifically approved by the U.S. FDA for metastatic OM. Your physician will advise you, based on your specific tumor characteristics and molecular genetics results (if available), of the treatments and investigational therapies in clinical trials best suited for you as listed below. When you are discussing treatment plans, always check ahead to make sure that the treatment plan you are considering will not disqualify you from a clinical trial you may choose to consider in the future. Having a next step treatment plan is a good way to be ready if your current treatment is not working. Your physician can help you develop a treatment plan with next steps and possible clinical trials that are right for you.
**The following are some treatments that may be suggested by your medical oncologist.
Liver-Directed Therapies Embolization (isolation of the liver) to locally administer chemotherapy, radiation or immunotherapy
Regional-Isolation Perfusion
HIA (Hepatic Intra-Arterial Chemotherapy) has not produced significant improvement in efficacy. Other liver-isolation therapies have subsequently been developed and tested as shown below.
IHP (Isolated Hepatic Infusion) The liver is completely isolated from the systemic blood circulation, allowing a high concentration of chemotherapy (typically melphalan) to be perfused through the liver. IHP can only be done once.
PHP (Percutaneous Hepatic Perfusion) is a double balloon catheter inserted into the inferior vena cava to isolate the blood supply to the liver and then the liver’s blood is filtered outside of the body. May be better tolerated than IHP, but efficacy results are lacking. IHP and PHP are less invasive and may be performed multiple times.
Hepatic chemoemolization drug eluting beads, gelatin sponge, polyvinyl sponge, resorbable microspheres and polyvinyl alcohol particles introduced into the liver. Chemoembolization has been well tolerated.
Hepatic immunoembolization
Immunologic stimulant is delivered into the hepatic artery followed by an embolizing agent.
Hepatic Radioembolization or hepatic trans-arterial radioemboliztion (TARE) or Selective Internal Radiation Therapy (SIRT) glass or resin yttrium-90 beads are introduced into the hepatic artery.
Tumor resection (removal from the liver or lungs) may be appropriate in some circumstances.
This is usually done when there are just few tumors which are easily accessible. Not all tumors can be resected. Embolization might be done as well.
Immunotherapy is an option, and you physician might recommend one of these investigational therapies:
Anti PD-1 / PD-L1 monotherapy: Pembrolizumab, Nivolumab
CTLA-4 Antibody: Ipilimumab
Checkpoint Inhibitor Combination: Nivolumab + Ipilimumab
Tumor Infiltrating Lymphocytes
Synthetic Melanoma Peptide Vaccination
Dendritic Cell Vaccination
Tentafusp (IMCgp100) is only available from at centers that participated in the recently completed Phase III clinical trial under special use. Contact your physician if you would like more information.
It is currently not FDA approved.
Targeted Therapies
IDE-196 (and in combination with Binimetinib)
Trametinib
Selumetinib
Defactinib + VS-6766
Cytotoxic Chemotherapy Drug Regimens
Temozolomide
Dacarbazine
Paclitaxel
Albumin-bound Paclitaxel
Carboplatin + paclitaxel
Ongoing clinical trials can be easily searched, using “Ocular Melanoma” or “Uveal Melanoma”:
https://clinicaltrials.gov/
Clinical trial results are published online from the leading Medical Oncology scientific groups:
(search recent Annual Meeting abstracts and presentations in “Ocular Melanoma” or “Uveal Melanoma”)
ASCO: https://conferences.asco.org/am/attend
ESMO: https://www.esmo.org/meetings/esmo-congress-2021
**Please note that A Cure In Sight does not offer treatment recommendations, and that the following listings are from publically-available website searches. Some of these investigational therapies may be already approved for other cancers, however there are currently no FDA-approved therapies specifically for metastatic OM.
I have recently found myself in a second ‘nightmare’ phase of this horrible disease – discovering metastasis. I don’t know what I would have done without my friends at ACIS. They are always there for me, providing emotional and social support, valuable information and insight, and helping me feel that I am not alone on this journey. It’s truly a blessing to have my new friends to talk things over with, who understand what I’m going through, and help me develop a plan of action. I am so grateful for ACIS!