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Advances in Treatment of Uveal Melanoma
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Advances in Treatment of Uveal Melanoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 9934

Special Issue Editors

Prof. Dr. Bożena Romanowska-Dixon

E-Mail Website
Guest Editor
1. Clinic of Ophthalmology and Ocular Oncology, University Hospital, 38 Kopernika Str., 31-501 Krakow, Poland
2. Department of Ophthalmology, Jagiellonian University Medical College, 38 Kopernika Str., 31-501 Krakow, Poland
Interests: uveal melanoma; metastases; treatment
Special Issues, Collections and Topics in MDPI journals
Dr. Michał S. Nowak

E-Mail Website
Guest Editor
Institute of Optics and Optometry, University of Social Sciences, 90-519 Lodz, Poland
Interests: ophthalmic epidemiology; public health; ocular oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Uveal melanoma (UM) is adults' most common primary intraocular tumor. The biology and immunology of UM significantly differ from cutaneous melanoma, which requires separate research efforts to elucidate treatment opportunities. Intraocular tumor is currently successfully treated mainly with radiotherapy, such as brachytherapy or proton beam. Surgical methods can also be used, including egzo or endo-resection, and enucleation in the case of some advanced stages. Despite effective local treatment, it is associated with death in approximately 50% of patients due to metastatic disease.  Metastases are mainly to the liver and other organs. We do not yet have effective methods of treating uveal melanoma metastases. Different characteristics of metastases require the development of treatment approaches, continuous use for optimal targeted therapy, and immunotherapy in adjuvant and metastatic settings. Understanding the biological mechanisms of UM development and metastatic spread will help to develop new possibilities for treating metastatic uveal melanoma in genetically and immunologically different groups of patients. The series of articles will be devoted to current data on the biology of UM, immunological, and genetic aspects that influence local treatment and treatment strategies for metastatic disease.

Prof. Dr. Bożena Romanowska-Dixon
Dr. Michał S. Nowak
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • uveal melanoma
  • distant metastases
  • treatment modalities

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Published Papers (5 papers)

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Research

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13 pages, 1260 KB  
Article
Unexpectedly Low Rate of Metastasis and Death Among Patients Treated for Uveal Melanoma with Brachytherapy, Vitrectomy, and Silicone Oil
by Axel Rivas, Wolfram Samlowski and Tara A. McCannel
Cancers 2025, 17(16), 2683; https://doi.org/10.3390/cancers17162683 - 18 Aug 2025
Cited by 3 | Viewed by 3202
Abstract
Introduction: Historically, approximately 30–32% of uveal melanoma patients develop metastases and die within 5 years. Larger tumor dimensions and monosomy 3 and/or Class 2 gene expression profile of the tumor are associated with an increased risk of metastasis. We evaluated the performance of [...] Read more.
Introduction: Historically, approximately 30–32% of uveal melanoma patients develop metastases and die within 5 years. Larger tumor dimensions and monosomy 3 and/or Class 2 gene expression profile of the tumor are associated with an increased risk of metastasis. We evaluated the performance of these prognostic markers in patients undergoing surveillance in a community medical oncology practice. Methods: Uveal melanoma patients treated by a single vitreoretinal surgical oncologist and monitored by a single medical oncologist were identified via a clinical database search for analysis. Specified prognostic markers were evaluated for sensitivity, specificity, positive and negative predictive value, as well as prognostic accuracy. Results: We identified 37 uveal melanoma patients, followed for a median of 4.0 ± 3.7 years. Twenty-seven (73%) patients underwent plaque brachytherapy with vitrectomy and silicone oil for radiation attenuation; seven (19%) patients underwent brachytherapy alone; three (8%) had enucleation. There were no intraocular treatment failures. Six (16.2%) patients developed metastasis, and only one patient died of metastatic disease. Disomy 3 and Class 1 accurately predicted a low risk for metastasis (>90% negative predictive value). However, monosomy 3 and Class 2 had a low positive predictive value and prognostic accuracy in “high-risk” patients. Conclusions: In this single-center cohort, we observed an unexpectedly low rate of 5-year metastasis. AJCC stage correlated poorly with metastasis or survival. Molecular prognostic results of Disomy 3 and Class 1 gene expression profile accurately predicted a “low” risk for metastasis (>90% negative predictive value). Further evaluation of these unique surgical techniques needs to be carried out. Full article
(This article belongs to the Special Issue Advances in Treatment of Uveal Melanoma)
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Review

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22 pages, 1173 KB  
Review
Current Treatment Standards for Metastatic Uveal Melanoma
by Paweł Rogala, Anna M. Czarnecka, Monika Dudzisz-Śledź, Anna Dawidowska, Kacper J. Piwowarek and Piotr Rutkowski
Cancers 2026, 18(3), 475; https://doi.org/10.3390/cancers18030475 - 31 Jan 2026
Viewed by 1207
Abstract
Background/Objectives: Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, most commonly arising in the choroid. Its development is associated with phenotypic characteristics, ultraviolet radiation, and germline or somatic genetic alterations. Despite progress in diagnostics and local therapies, UM remains [...] Read more.
Background/Objectives: Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, most commonly arising in the choroid. Its development is associated with phenotypic characteristics, ultraviolet radiation, and germline or somatic genetic alterations. Despite progress in diagnostics and local therapies, UM remains characterized by high metastatic risk and poor overall prognosis. This review aimed to summarize current knowledge on epidemiology, clinical features, genetic background, prognostic factors, and therapeutic approaches in metastatic UM. Methods: A structured literature review was conducted to evaluate epidemiological trends, genetic alterations, prognostic markers, clinical presentation, and therapeutic strategies. The results of different systemic treatments were analyzed, with special attention to liver-directed interventions and emerging systemic therapies. Results: The incidence of UM in Europe increases with latitude, ranging from two per million in the southern regions to more than eight per million in the North. The median age at diagnosis is 62 years, and most cases are detected incidentally during ophthalmological examinations due to nonspecific symptoms. Some genetic alterations serve as important prognostic indicators. Local treatment consists of globe-preserving procedures, including radiation therapy, surgery, laser therapy, or enucleation, with failure rates between 6.15% and 20.8%. Up to 70% of patients develop distant metastases, predominantly in the liver. Metastatic UM (mUM) carries a poor prognosis, with overall survival ranging from 3 to 30 months. Liver-directed therapies, particularly surgical resection, provide the most favorable outcomes. Systemic therapies demonstrate limited efficacy; however, tebentafusp has shown an overall survival benefit in HLA-A*02:01 (human leukocyte antigen A*02:01)-positive patients. Conclusions: UM is a rare but aggressive malignancy with limited treatment options once metastatic. Liver-directed strategies remain the mainstay of management, while novel systemic approaches, including tebentafusp, represent promising advances. Further research is required to improve survival and expand therapeutic opportunities. Full article
(This article belongs to the Special Issue Advances in Treatment of Uveal Melanoma)
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19 pages, 15956 KB  
Review
Clinical Characteristics and Management of Ocular Metastases
by Karolina Gerba-Górecka, Bożena Romanowska-Dixon, Izabella Karska-Basta, Ewelina Cieplińska-Kechner and Michał S. Nowak
Cancers 2025, 17(6), 1041; https://doi.org/10.3390/cancers17061041 - 20 Mar 2025
Cited by 8 | Viewed by 4120
Abstract
Intraocular metastases represent the most common type of intraocular tumors in adults. In most cases, the metastases originate from primary breast and lung cancers. Effective management of patients with intraocular metastatic disease requires a multidisciplinary approach involving ophthalmologists, oncologists, and radiation therapists. The [...] Read more.
Intraocular metastases represent the most common type of intraocular tumors in adults. In most cases, the metastases originate from primary breast and lung cancers. Effective management of patients with intraocular metastatic disease requires a multidisciplinary approach involving ophthalmologists, oncologists, and radiation therapists. The primary goals of treatment are disease control, maintenance of optimal quality of life, and preservation of functional vision. This article provides an in-depth overview of intraocular metastases, with special emphasis on the practical aspects of their diagnosis and treatment based on the most recent literature. Full article
(This article belongs to the Special Issue Advances in Treatment of Uveal Melanoma)
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Other

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3 pages, 163 KB  
Reply
Reply to Correa et al. Comment on “Rivas et al. Unexpectedly Low Rate of Metastasis and Death Among Patients Treated for Uveal Melanoma with Brachytherapy, Vitrectomy, and Silicone Oil. Cancers 2025, 17, 2683”
by Axel Rivas, Wolfram Samlowski and Tara A. McCannel
Cancers 2026, 18(8), 1224; https://doi.org/10.3390/cancers18081224 - 13 Apr 2026
Viewed by 307
Abstract
We thank the leadership of the Collaborative Ocular Oncology Group (COOG) for their thoughtful comments [...] Full article
(This article belongs to the Special Issue Advances in Treatment of Uveal Melanoma)
2 pages, 149 KB  
Comment
Comment on Rivas et al. Unexpectedly Low Rate of Metastasis and Death Among Patients Treated for Uveal Melanoma with Brachytherapy, Vitrectomy, and Silicone Oil. Cancers 2025, 17, 2683
by Zelia M. Correa, J. William Harbour, Brian P. Marr, Prithvi Mruthyunjaya, David Reichstein, Miguel A. Materin, Amy C. Schefler and Alison Skalet
Cancers 2026, 18(8), 1208; https://doi.org/10.3390/cancers18081208 - 10 Apr 2026
Cited by 1 | Viewed by 295
Abstract
As the executive leadership of the Collaborative Ocular Oncology Group (COOG), which has conducted the largest prospective clinical studies ever performed in patients with uveal melanoma, we read with concern the recent report by Rivas, Samlowski and McCannel, which claims that brachytherapy combined [...] Read more.
As the executive leadership of the Collaborative Ocular Oncology Group (COOG), which has conducted the largest prospective clinical studies ever performed in patients with uveal melanoma, we read with concern the recent report by Rivas, Samlowski and McCannel, which claims that brachytherapy combined with vitrectomy and silicone oil injection results in an “unexpectedly low rate” of metastasis and death in patients with uveal melanoma [...] Full article
(This article belongs to the Special Issue Advances in Treatment of Uveal Melanoma)
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