Systemic treatment of metastatic uveal melanoma: review of literature and future perspectives

摘要: Up to 50% of patients with uveal melanoma develop metastatic disease poor prognosis. Regional, mainly liver-directed, therapies may induce limited tumor responses but do not improve overall survival. Response rates (MUM) systemic chemotherapy are poor. Insights into the molecular biology MUM recently led investigation new drugs. In this study, compare response treatment for we searched Pubmed/Web Knowledge databases and ASCO website (1980–2013) “metastatic/uveal/melanoma” “melanoma/eye.” Forty studies (one case series, three phase I, five pilot, 22 nonrandomized, two randomized II, one III data expanded access programs, retrospective studies) 841 evaluable were included in numeric outcome analysis. Complete or partial remissions observed 39/841 (overall rate [ORR] 4.6%; 95% confidence intervals [CI] 3.3–6.3%), no 22/40 studies. Progression-free survival ranged from 1.8 7.2, median 5.2 19.0 months as reported 21/40 26/40 studies, respectively. Best seen chemoimmunotherapy (ORR 10.3%; CI 4.8–18.7%) though first-line patients. Immunotherapy ipilimumab, antiangiogenetic approaches, kinase inhibitors have yet proven be superior chemotherapy. MEK currently investigated a II trial promising preliminary data. Despite insights genetic background MUM, satisfying approaches lacking. Study results innovative strategies urgently awaited. Forty clinical on reviewed regarding treatments. New substances vitro been translated responses; however, ongoing highly encouraging.