- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
Uveal melanoma is the most common primary intraocular malignancy in adults. Although it is relatively rare, it is extremely malignant, with poor treatment effect. The current treatment for primary lesions can achieve ideal local control, but there are still nearly half of the patients with distant metastasis. This article reviews the epidemiology, genetic status, diagnosis, treatment and prognosis of uveal melanoma in combination with recent advances in diagnostic and therapeutic techniques.
Citation: XIANG Zhongzheng, LIU Lei. Progress in diagnosis and treatment of uveal melanoma. West China Medical Journal, 2018, 33(11): 1433-1440. doi: 10.7507/1002-0179.201810077 Copy
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2. | Singh AD, Topham A. Incidence of uveal melanoma in the United States: 1973-1997. Ophthalmology, 2003, 110(5): 956-961. |
3. | Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer, 1998, 83(8): 1664-1678. |
4. | Shields CL, Furuta M, Thangappan A, et al. Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes. Arch Ophthalmol, 2009, 127(8): 989-998. |
5. | Liu YM, Li Y, Wei WB, et al. Clinical characteristics of 582 patients with uveal melanoma in China. PLoS One, 2015, 10(12): e0144562. |
6. | Cerbone L, Van Ginderdeuren R, Van den Oord JA, et al. Clinical presentation, pathological features and natural course of metastatic uveal melanoma, an orphan and commonly fatal disease. Oncology, 2014, 86(3): 185-189. |
7. | Virgili G, Gatta G, Ciccolallo L, et al. Survival in patients with uveal melanoma in Europe. Arch Ophthalmol, 2008, 126(10): 1413-1418. |
8. | Kujala E, Mäkitie T, Kivelä T. Very long-term prognosis of patients with malignant uveal melanoma. Invest Ophthalmol Vis Sci, 2003, 44(11): 4651-4659. |
9. | Rietschel P, Panageas KS, Hanlon C, et al. Variates of survival in metastatic uveal melanoma. J Clin Oncol, 2005, 23(31): 8076-8080. |
10. | Singh AD, Turell ME, Topham AK. Uveal melanoma: trends in incidence, treatment, and survival. Ophthalmology, 2011, 118(9): 1881-1885. |
11. | Virgili G, Gatta G, Ciccolallo L, et al. Incidence of uveal melanoma in Europe. Ophthalmology, 2007, 114(12): 2309-2315. |
12. | Hu DN, Yu GP, Mccormick SA, et al. Population-based incidence of uveal melanoma in various races and ethnic groups. Am J Ophthalmol, 2005, 140(4): 612-617. |
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- 2. Singh AD, Topham A. Incidence of uveal melanoma in the United States: 1973-1997. Ophthalmology, 2003, 110(5): 956-961.
- 3. Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer, 1998, 83(8): 1664-1678.
- 4. Shields CL, Furuta M, Thangappan A, et al. Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes. Arch Ophthalmol, 2009, 127(8): 989-998.
- 5. Liu YM, Li Y, Wei WB, et al. Clinical characteristics of 582 patients with uveal melanoma in China. PLoS One, 2015, 10(12): e0144562.
- 6. Cerbone L, Van Ginderdeuren R, Van den Oord JA, et al. Clinical presentation, pathological features and natural course of metastatic uveal melanoma, an orphan and commonly fatal disease. Oncology, 2014, 86(3): 185-189.
- 7. Virgili G, Gatta G, Ciccolallo L, et al. Survival in patients with uveal melanoma in Europe. Arch Ophthalmol, 2008, 126(10): 1413-1418.
- 8. Kujala E, Mäkitie T, Kivelä T. Very long-term prognosis of patients with malignant uveal melanoma. Invest Ophthalmol Vis Sci, 2003, 44(11): 4651-4659.
- 9. Rietschel P, Panageas KS, Hanlon C, et al. Variates of survival in metastatic uveal melanoma. J Clin Oncol, 2005, 23(31): 8076-8080.
- 10. Singh AD, Turell ME, Topham AK. Uveal melanoma: trends in incidence, treatment, and survival. Ophthalmology, 2011, 118(9): 1881-1885.
- 11. Virgili G, Gatta G, Ciccolallo L, et al. Incidence of uveal melanoma in Europe. Ophthalmology, 2007, 114(12): 2309-2315.
- 12. Hu DN, Yu GP, Mccormick SA, et al. Population-based incidence of uveal melanoma in various races and ethnic groups. Am J Ophthalmol, 2005, 140(4): 612-617.
- 13. Andreoli MT, Mieler WF, Leiderman YI. Epidemiological trends in uveal melanoma. Br J Ophthalmol, 2015, 99(11): 1550-1553.
- 14. Shields CL, Kaliki S, Arepalli S, et al. Uveal melanoma in children and teenagers. Saudi J Ophthalmol, 2013, 27(3): 197-201.
- 15. Singh AD, Schoenfield LA, Bastian BC, et al. Congenital uveal melanoma?. Surv Ophthalmol, 2016, 61(1): 59-64.
- 16. Shields CL, Kaliki S, Cohen MN, et al. Prognosis of uveal melanoma based on race in 8100 patients: the 2015 Doyne Lecture. Eye (Lond), 2015, 29(8): 1027-1035.
- 17. Vajdic CM, Kricker A, Giblin M, et al. Eye color and cutaneous nevi predict risk of ocular melanoma in Australia. Int J Cancer, 2001, 92(6): 906-912.
- 18. Weis E, Shah CP, Lajous M, et al. The association between host susceptibility factors and uveal melanoma: a meta-analysis. Arch Ophthalmol, 2006, 124(1): 54-60.
- 19. Onken MD, Worley LA, Ehlers JP, et al. Gene expression profiling in uveal melanoma reveals two molecular classes and predicts metastatic death. Cancer Res, 2004, 64(20): 7205-7209.
- 20. Field MG, Harbour JW. Recent developments in prognostic and predictive testing in uveal melanoma. Curr Opin Ophthalmol, 2014, 25(3): 234-239.
- 21. Harbour JW, Onken MD, Roberson ED, et al. Frequent mutation of BAP1 in metastasizing uveal melanomas. Science, 2010, 330(69): 1410-1413.
- 22. Harbour JW, Roberson ED, Anbunathan HA, et al. Recurrent mutations at codon 625 of the splicing factor SF3B1 in uveal melanoma. Nat Genet, 2013, 45(2): 133-135.
- 23. Onken MD, Worley LA, Long MD, et al. Oncogenic mutations in GNAQ occur early in uveal melanoma. Invest Ophthalmol Vis Sci, 2008, 49(12): 5230-5234.
- 24. van Raamsdonk CD, Bezrookove V, Green GA, et al. Frequent somatic mutations of GNAQ in uveal melanoma and blue naevi. Nature, 2009, 457(7229): 599-602.
- 25. Van Raamsdonk CD, Griewank KG, Crosby MB, et al. Mutations in GNA11 in uveal melanoma. N Engl J Med, 2010, 363(23): 2191-2199.
- 26. Martin M, Maßhöfer L, Temming P, et al. Exome sequencing identifies recurrent somatic mutations in EIF1AX and SF3B1 in uveal melanoma with disomy 3. Nat Genet, 2013, 45(8): 933-936.
- 27. Jensen DE, Proctor M, Marquis ST, et al. BAP1: a novel ubiquitin hydrolase which binds to the BRCA1 RING finger and enhances BRCA1-mediated cell growth suppression. Oncogene, 1998, 16(9): 1097-1112.
- 28. Johansson P, Aoude LG, Wadt K, et al. Deep sequencing of uveal melanoma identifies a recurrent mutation in PLCB4. Oncotarget, 2016, 7(4): 4624-4631.
- 29. Dono M, Angelini G, Cecconi M, et al. Mutation frequencies of GNAQ, GNA11, BAP1, SF3B1, EIF1AX and TERT in uveal melanoma: detection of an activating mutation in the TERT gene promoter in a single case of uveal melanoma. Br J Cancer, 2014, 110(4): 1058-1065.
- 30. Koopmans AE, Verdijk RM, Brouwer RW, et al. Clinical significance of immunohistochemistry for detection of BAP1 mutations in uveal melanoma. Mod Pathol, 2014, 27(10): 1321-1330.
- 31. van de Nes JA, Nelles J, Kreis S, et al. Comparing the prognostic value of BAP1 mutation pattern, chromosome 3 status, and BAP1 immunohistochemistry in uveal melanoma. Am J Surg Pathol, 2016, 40(6): 796-805.
- 32. Decatur CL, Ong E, Garg N, et al. Driver mutations in uveal melanoma associations with gene expression profile and patient outcomes. JAMA Ophthalmol, 2016, 134(7): 728-733.
- 33. Ewens KG, Kanetsky PA, Richards-Yutz JA, et al. Chromosome 3 status combined with BAP1 and EIF1AX mutation profiles are associated with metastasis in uveal melanoma. Invest Ophthalmol Vis Sci, 2014, 55(8): 5160-5167.
- 34. Xu C, Wu QX, Tan LJ, et al. Combined PKC and MEK inhibition in uveal melanoma with GNAQ and GNA11 mutations. Oncogene, 2014, 33(39): 4724-4734.
- 35. Daniels AB, Lee JE, Macconaill LE, et al. High throughput mass spectrometrybased mutation profiling of primary uveal melanoma. Invest Ophthalmol Vis Sci, 2012, 53(11): 6991-6996.
- 36. Bauer J, Kilic E, Vaarwater J, et al. Oncogenic GNAQ mutations are not correlated with disease-free survival in uveal melanoma. Br J Cancer, 2009, 101(5): 813-815.
- 37. Koopmans AE, Vaarwater J, Paridaens D, et al. Patient survival in uveal melanoma is not affected by oncogenic mutations in GNAQ and GNA11. Br J Cancer, 2013, 109(2): 493-496.
- 38. Weber A, Hengge UR, Urbanik D, et al. Absence of mutations of the BRAF gene and constitutive activation of extracellular-regulated kinase in malignant melanomas of the uvea. Lab Invest, 2003, 83(12): 1771-1776.
- 39. Zuidervaart W, van Nieuwpoort F, Stark M, et al. Activation of the MAPK pathway is a common event in uveal melanomas although it rarely occurs through mutation of BRAF or RAS. Br J Cancer, 2005, 92(11): 2032-2038.
- 40. von Euw E, Atefi M, Attar N, et al. Antitumor effects of the investigational selective MeK inhibitor TAK733 against cutaneous and uveal melanoma cell lines. Mol Cancer, 2012, 11: 22.
- 41. Mahipal A, Tijani L, Chan K, et al. A pilot study of sunitinib malate in patients with metastatic uveal melanoma. Melanoma Res, 2012, 22(6): 440-446.
- 42. Carvajal RD, Sosman JA, Quevedo JF, et al. Effect of selumetinib vs chemotherapy on progression-free survival in uveal melanoma a randomized clinical trial. JAMA, 2014, 311(23): 2397-2405.
- 43. Golas MM, Sander B, Will CL, et al. Molecular architecture of the multiprotein splicing factor SF3b. Science, 2003, 300(5621): 980-984.
- 44. te Raa GD, Derks I, Navrkalova V, et al. The impact of SF3B1 mutations in CLL on the DNA-damage response. Leukemia, 2015, 29(5): 1133-1142.
- 45. Furney SJ, Pedersen M, Gentien D, et al. SF3B1 mutations are associated with alternative splicing in uveal melanoma. Cancer Discov, 2013, 3(10): 1122-1129.
- 46. Yavuzyigitoglu S, Koopmans AE, Verdijk RM, et al. Uveal melanomas with SF3B1 mutations a distinct subclass associated with late-onset metastases. Ophthalmology, 2016, 123(5): 1118-1128.
- 47. Eskelin S, Kivela T. Mode of presentation and time to treatment of uveal melanoma in Finland. Br J Ophthalmol, 2002, 86(3): 333-338.
- 48. The Collaborative Ocular Melanoma Study Group. Factors predictive of growth and treatment of small choroidal melanoma: COMS Report. Arch Ophthalmol, 1997, 115(12): 1537-1544.
- 49. Collaborative Ocular Melanoma Study Group. Accuracy of diagnosis of choroidal melanomas in the Collaborative Ocular Melanoma Study. COMS report no. 1. Arch Ophthalmol, 1990, 108(9): 1268-1273.
- 50. Shields CL, Shields JA, Perez N, et al. Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology, 2002, 109(2): 225-234.
- 51. Yarovoy AA, Magaramov DA, Bulgakova ES. The comparison of ruthenium brachytherapy and simultaneous transpupillary thermotherapy of choroidal melanoma with brachytherapy alone. Brachytherapy, 2012, 11(3): 224-229.
- 52. Tarmann L, Wackernagel W, Avian A, et al. Ruthenium-106 plaque brachytherapy for uveal melanoma. Br J Ophthalmol, 2015, 99(12): 1644-1649.
- 53. Collaborative Ocular Melanoma Study Group. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol, 2006, 124(12): 1684-1693.
- 54. Sagoo MS, Shields CL, Mashayekhi AA, et al. Plaque radiotherapy for juxtapapillary choroidal melanoma tumor control in 650 consecutive cases. Ophthalmology, 2011, 118(2): 402-407.
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