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Immunotherapy for metastatic uveal melanoma

A guide to the immunotherapy drugs that are being used to treat some cases of metastatic uveal melanoma.

A senior man with a cotton ball bandaged to his arm after a blood test. A blood test can determine if a person can be treated with immunotherapy for metastatic uveal melanoma.

Updated on March 14, 2024

Metastatic uveal melanoma is a type of cancer that originates in the tissues of the uvea (the middle layer of the eye) and has spread to other sites in the body (such as the liver, lungs, bone, and/or skin). There is no cure for this type of cancer, but there are treatments that can help a person live longer.

As with many other cancers, the treatment of metastatic uveal melanoma is individualized. This means that each person’s treatment plan is a bit different. Recommendations for treatment are based on factors like the size and location of the tumor in the eye, the sites in the body where the cancer has spread to, the preferences of the person being treated, and the results of diagnostic tests.

Surgery and radiation therapy remain the most-used treatments for uveal melanomas, including metastatic uveal melanomas. Chemotherapy is also used in some cases. However, treatment options for metastatic uveal melanoma are expanding to include other approaches, including immunotherapy.

Immunotherapy refers to cancer treatments that help the body’s immune system detect and attack cancerous cells.

Immunotherapy for metastatic uveal melanoma

New therapies to treat uveal melanoma (including metastatic uveal melanoma) are under development. The first treatment specifically for metastatic uveal melanoma became available in 2022. It is an immunotherapy that works by engaging T cells, a type of white blood cell that can destroy diseased cells.

  • This therapy can be used in people with metastatic uveal melanoma who are HLA-A*02:01 positive.
  • A blood test can determine if a person is HLA-A*02:01 positive. This blood test looks for inherited genetic variations in cells called human leukocyte antigens (HLAs).
  • HLAs are found on most cells in the body. They help the immune system distinguish between healthy cells that belong in the body and diseased cells that do not belong (like cancerous cells).
  • While every person has HLAs, everyone’s genetics are different, and HLAs vary from one person to the next. Only some people are HLA-A*02:01 positive.
  • Like other immunotherapies, this drug helps the body’s immune system fight cancer cells. More specifically, it helps bring T cells to the cancerous cells.

Keep in mind that this is a simplified explanation. For questions about HLA-A*02:01 status or more detail on how specific cancer therapies work, a healthcare provider will always be your best source of information.

Also keep in mind that immunotherapies and other cancer treatments can cause side effects. Before starting a treatment, talk to your healthcare providers about potential side effects, the risk of serious side effects, and how you will be monitored for side effects.

Immune checkpoint inhibitors

Though it’s not a common approach to treatment, immunotherapy drugs called immune checkpoint inhibitors are sometimes used in the treatment of metastatic uveal melanoma:

  • Immune checkpoints are proteins found on the surface of normal cells—and in some cases, cancerous cells.
  • Immune checkpoints prevent T cells from attacking. This helps prevent the immune system from damaging healthy cells.
  • When cancer cells have immune checkpoints, it prevents the immune system from attacking the cancer.
  • Immune checkpoint inhibitors switch off immune checkpoints, which helps T cells attack, detect, and destroy cancer cells.

Again, this is not a common approach to treating uveal melanomas, but it has been studied, and it may be prescribed in some cases. Several immune checkpoint inhibitors may be used in combination with each other, and these drugs may be used in combination with chemotherapy drugs.

Article sources open article sources

Divakar Gupta, Adam R. Sweeney, et al. Uveal Melanoma. American Academy of Ophthalmology EyeWiki. October 15, 2023.
National Organization for Rare Disorders. Ocular Melanoma.
American Cancer Society. Treating Eye Melanoma by Location and Size.
American Cancer Society. What’s New in Eye Cancer Research?
American Society of Clinical Oncology.  Eye Melanoma: Latest Research.
National Institute of Environmental Health Sciences. Biomarkers.
NCI Dictionary of Cancer Terms. Biomarker.
American Cancer Society. Biomarker Tests and Cancer Treatment.
American Cancer Society. Breast Cancer Hormone Receptor Status.
NCI Dictionary of Cancer Terms. HLA-A*02:01 antigen.
MedlinePlus. EGFR gene.
National Cancer Institute. Tumor Marker Tests in Common Use.
National Cancer Institute. Biomarker Testing for Cancer Treatment.
American Cancer Society. Immunotherapy and Targeted Drugs for Eye Cancer.
Shujie Zhou, Mingguo Liu, et al. The landscape of bispecific T cell engager in cancer treatment. Biomarker Research, 2021. Vol. 9.
Science Direct. Human Leukocyte Antigen.
Peter J. Delves. Human Leukocyte Antigen (HLA) System. Merck Manual Professional Version. February 2024.
The Sequencing Center. The HLA-A Gene.
Helen Nordquist and Radia T. Jamil. Biochemistry, HLA Antigens. StatPearls. April 24, 2023.
Genomind. HLA-A & HLA-B Gene Spotlight. November 22, 2021.
Nadia Jaber. Cancer Immunotherapies Don’t Work for Everyone: HLA Gene May Explain Why. National Cancer Institute. January 27, 2022.
NCI Dictionary of Cancer Terms. T cell.
National Cancer Institute. Immune Checkpoint Inhibitors.
Daniel Constantin Branisteanu, Camelia Margareta Bogdanici, et al. Uveal melanoma diagnosis and current treatment options (Review). Experimental and Therapeutic Medicine, 2021. Vol. 22, No. 6.

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