Sussman Tamara A, Funchain Pauline, Singh Arun
Department of Hematology/Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Ocul Oncol Pathol. 2020 Dec;6(6):381-387. doi: 10.1159/000508383. Epub 2020 Sep 10.
Uveal melanoma is a rare subtype of melanoma. Prognosis and survival rates for patients with metastatic uveal melanoma remain poor. No current FDA-approved standard of care therapy is available for patients with metastatic uveal melanoma. Thus, clinical trials are essential for the development of new therapies and to provide patients hope for improved survival and outcomes.
In this article, we review clinical trials identified on the database https://clinicaltrials.gov that are open and enrolling patients with metastatic uveal melanoma as of November 26, 2019. This search produced 17 active trials involving liver-directed therapy, CNS-directed therapy, and systemic therapy with immunotherapy, targeted therapy, or oncolytic virus therapy. Here, we discuss liver and CNS-directed therapy as well as systemic targeted therapy and oncolytic virus therapy. Immunotherapy clinical trials are discussed in a companion review article by Dr. Marlana Orloff.
Various novel therapeutic targets and immunomodulatory approaches are on the horizon for patients with metastatic uveal melanoma and may yield incremental therapeutic benefit. Selecting a clinical trial must be individualized and made jointly with the patient and his/her oncologist.
葡萄膜黑色素瘤是黑色素瘤的一种罕见亚型。转移性葡萄膜黑色素瘤患者的预后和生存率仍然很差。目前美国食品药品监督管理局(FDA)尚未批准用于转移性葡萄膜黑色素瘤患者的标准护理疗法。因此,临床试验对于开发新疗法以及为患者提供改善生存和预后的希望至关重要。
在本文中,我们回顾了截至2019年11月26日在数据库https://clinicaltrials.gov上确定的、正在招募转移性葡萄膜黑色素瘤患者的开放临床试验。此次检索产生了17项正在进行的试验,涉及肝导向治疗、中枢神经系统(CNS)导向治疗以及采用免疫疗法、靶向疗法或溶瘤病毒疗法的全身治疗。在此,我们讨论肝导向治疗和中枢神经系统导向治疗以及全身靶向治疗和溶瘤病毒治疗。免疫疗法的临床试验将在玛拉娜·奥尔洛夫博士的一篇配套综述文章中进行讨论。
对于转移性葡萄膜黑色素瘤患者而言,各种新的治疗靶点和免疫调节方法即将出现,可能会带来更多的治疗益处。选择临床试验必须因人而异,并由患者及其肿瘤学家共同做出决定。