How we treat patients with metastatic uveal melanoma

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2025-03-19 DOI:10.1016/j.esmoop.2025.104496

E.F. Saldanha , M.F. Ribeiro , I. Hirsch , A. Spreafico, S.D. Saibil , M.O. Butler

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引用次数: 0

Abstract

Uveal melanoma is the most prevalent and aggressive intraocular malignancy affecting adults. Compared with cutaneous melanoma, uveal melanoma has distinct pathogenesis and molecular characteristics. Not surprisingly, it derives limited benefits from checkpoint inhibitors. Until recently, no systemic therapy had impacted survival outcomes for this patient population. Tebentafusp, a T-cell receptor-based molecule, is the first US Food and Drug Administration/European Medicines Agency-approved systemic therapy to improve the survival outcomes for uveal melanoma patients expressing HLA-A∗02:01. Only 45%-50% of this patient population will express the HLA-A∗02:01, however, and therefore are eligible to receive this novel treatment. Moreover, global access to tebentafusp is limited, and there are no guidelines to aid clinicians in decision-making regarding treatment. In this review, we outline our experience as Canada's largest tertiary referral centre in managing metastatic uveal melanoma patients and provide a comprehensive overview of the currently available treatment options, challenging scenarios, and ongoing clinical trials for patients with metastatic uveal melanoma.

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眼色素膜黑色素瘤是影响成年人的最常见和最具侵袭性的眼内恶性肿瘤。与皮肤黑色素瘤相比，葡萄膜黑色素瘤具有独特的发病机制和分子特征。检查点抑制剂对它的治疗效果有限也就不足为奇了。直到最近，还没有一种系统性疗法能对这一患者群体的生存结果产生影响。Tebentafusp是一种基于T细胞受体的分子，是美国食品药品管理局/欧洲药品管理局批准的第一种系统疗法，可改善表达HLA-A∗02:01的葡萄膜黑色素瘤患者的生存预后。不过，只有 45%-50% 的患者表达 HLA-A∗02:01，因此有资格接受这种新型疗法。此外，在全球范围内获得特本芴素的机会有限，也没有任何指南来帮助临床医生做出治疗决策。在这篇综述中，我们概述了加拿大最大的三级转诊中心在治疗转移性葡萄膜黑色素瘤患者方面的经验，并全面介绍了目前可用的治疗方案、具有挑战性的情况以及针对转移性葡萄膜黑色素瘤患者正在进行的临床试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.