About Uveal Melanoma
Uveal melanoma is the most common primary intraocular malignancy in adults, arising from melanocytes of the uveal tract (choroid, ciliary body, or iris) and driven by activating somatic mutations in GNAQ or GNA11 in approximately 80% of cases, resulting in constitutive MAPK and YAP pathway signalling. Unlike cutaneous melanoma, uveal melanoma is largely unresponsive to anti-PD-1 checkpoint inhibitors used in isolation and lacks high tumour mutational burden or UV-signature mutations. Approximately 50% of patients develop metastatic disease, almost exclusively to the liver, with a median survival of 6–12 months from metastatic diagnosis; tebentafusp (a bispecific gp100-CD3 fusion protein) is the only therapy demonstrating improved overall survival in HLA-A*02:01-positive patients.
Common Clinical Features
Clinical Trial Eligibility Tips
What to know before applying to Uveal Melanoma trials.
HLA-A*02:01 genotyping is mandatory for tebentafusp eligibility (approximately 40–50% of Caucasian patients are positive) — request HLA typing early as processing time may delay trial screening.
BAP1 mutation and monosomy 3 status, determined from enucleation specimen or biopsy, are critical prognostic and eligibility markers for adjuvant and metastatic trials — confirm availability of tumour molecular data.
Liver metastasis pattern (number and size of lesions) and hepatic reserve (liver function tests, Child-Pugh score) are key eligibility criteria for liver-directed and systemic therapy trials; provide recent cross-sectional imaging and laboratory values.
Patient Resources
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