Many medical centers across the nation are doing research on the causes and treatment of eye cancers. These are challenging diseases to study because they are not common. But each year scientists find out more about what causes them and how to improve treatment.
Genetics
Learning more about the gene changes involved in these cancers will likely play an important role in treating intraocular melanomas, intraocular lymphomas, and other eye cancers in the future. As we learn about the gene changes in these cancers, we may be able to develop tests to identify people who are more likely to get them and carefully screen those people.
Genetic profiles of tumors may also help predict the likelihood of the tumor spreading. For example, in uveal melanoma, certain genetic changes, such as the loss of one copy of chromosome 3, have been linked to an increased risk cancer spread. Some doctors may test for these changes to try to identify patients who might benefit from more aggressive treatment.
Identifying gene changes might also provide specific targets for which newer drugs may work (see targeted therapy below). This is an active area of research.
Immunotherapies
Immunotherapies are treatments that boost the body's own immune system in an attempt to get it to attack the cancer. Cytokines, monoclonal antibodies, vaccines, and other immunotherapies are among the most promising approaches for treating melanoma and lymphoma. Although most clinical trials of these treatments include people with melanomas of the skin and lymphomas that begin in lymph nodes, results of these studies may help treat people with intraocular melanoma and lymphoma as well.
An example is ipilimumab (Yervoy), a type of drug called a monoclonal antibody that boosts the overall activity of the immune system. It has been shown to help people with advanced melanomas of the skin live longer, although it can also have some serious side effects. It is not yet clear if this or similar drugs may help against melanomas of the eye.
Targeted therapy
As researchers have learned more about some of the changes in cells that cause them to become cancerous, they have begun to develop drugs that target these changes. These new targeted drugs work differently from standard chemo drugs. They tend to have different (and often less severe) side effects. They can be used alone or along with other drugs.
Most targeted cancer therapies do not damage bone marrow or blood cells like most standard chemo drugs do. But even though they mainly target the cancer cells, these drugs can still cause side effects and sometimes serious reactions.
Many targeted drugs are already in use to treat other types of cancer. Some of these drugs are now being studied for use against melanoma of the eye as well, including sunitinib (Sutent®), imatinib (Gleevec), and everolimus (Afinitor®).
A newer drug called vemurafenib, which targets a mutation in the BRAF gene, shows great promise for melanoma. This mutation is found in about half of patients with skin melanoma, but only in about 5% of patients with intraocular melanoma.
Other drugs target the blood vessels that allow tumors to grow. These are known as anti-angiogenesis drugs. One example is bevacizumab (Avastin®), which is already used to treat some other types of cancer. It may help prevent some of the side effects from radiation, which may help patients retain more vision after treatment. It is also being studied for use along with chemotherapy.
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