The World Ophthalmology Congress, organized by the International Council of Ophthalmology, was an outstanding meeting! It was really motivating to see how multiple groups across the world are fighting uveal melanoma, both in the clinic and research settings.
Starting with research updates, Dr. Shahar Frenkle (Hadassah-Hebrew University Medical School, Jerusalem, Israel) explained his findings on how uveal melanoma cancer cells can surprisingly thrive in an adverse environment with low oxygen supply (which not all cancer cells can do) and why this atypical feature might be used in future UM therapies. Also, the tumour environment plays a role: Dr. Mathew Wilson (Hamilton Eye Institute, Memphis, USA) explained how liver inflammasomes (molecules normally present at the liver responsible for controlling inflammatory damage) are downregulated in the setting of UM liver metastases, allowing tumour proliferation. Better understanding of these mechanisms might lead to possible weapons against UM’s metastatic processes.
Dr. Carol Shields (Wills Eye Hospital, Philadelphia, USA), elaborated on her experience with current new therapies available at her centre. She talked about the emerging role of ImmTAC, a drug that redirects the organism own cells to attack cancerous ones, since recent and promising data shows that immunotherapy may work after a previous priming with this drug in some UM cases (you can find more detailed information about these types of therapies in a recent UM Cure 2020 digest here). Dr. Shields also talked about the role of Sunitinib, a drug that stops cancer cells from receiving needed stimuli to grow, in adjuvant therapy (a therapeutic agent given after the treatment of the ocular tumour to prevent further tumour dissemination). Plaque radiotherapy is often the first line of therapy in the US for medium sized UM and its effectiveness and side-effects are well studied. Dr. Shields reported that, in her experience, anti-VEGF therapy (a drug that prevents vessels formation) has a role in preventing post-radiotherapy complications.
More evidence was discussed on how genetic information could benefit UM’s prognostication algorithms that are exclusively based on anatomical features. Dr. Hatem Krema (University of Toronto, Toronto, Canada) demonstrated in his research group how this is particularly true for patients with tumours whose classification falls in the middle AJCC 8th edition stages (a current classification used based on the size and location of tumour – to know more click here). Although genetic testing didn’t significantly alter the predicted survival in early and advanced AJCC stages of uveal melanoma, in his analysis, addition of genomic data to clinical data provided a significant change in the predicted survival rates, for patients with medium sized melanoma.
Overall,in addition and collectively with the UM Cure 2020 consortium, many efforts around the world are being made to better understand uveal melanoma in the hope of achieving a possible cure.