Targeted Drugs and Immune Therapy for Eye Cancer
Medicines for eye melanoma
Melanoma that has spread outside of the eye can be hard to treat, and unfortunately standard chemotherapy drugs often are not very helpful.
In recent years, researchers have developed newer types of drugs to treat advanced melanomas. Several of these drugs are now used to treat melanomas of the skin, but it’s not yet clear if they will be as helpful in treating uveal (eye) melanomas. These newer drugs generally fall into 2 groups.
Immunotherapy drugs: These drugs work by helping the body’s own immune system recognize and attack cancer cells. Drugs such as pembrolizumab (Keytruda®) and ipilimumab (Yervoy®) have been shown to help some people with melanoma of the skin. These and some other immunotherapy drugs are now being studied for eye melanomas as well.
Targeted drugs: Some newer drugs target parts of melanoma cells that make them different from normal cells. For example, about half of all skin melanomas have a change (mutation) in a gene called BRAF, and several drugs that target this gene change are now available to treat these cancers. Unfortunately, this mutation is much less common in uveal melanomas, but in people who have it, these drugs might be helpful. Drugs targeting other gene changes are now being studied as well.
For more information on some of these newer drugs, see “ What’s new in eye cancer research and treatment?”
Monoclonal antibodies for eye lymphoma
Antibodies are proteins normally made by the immune system to help fight infections. Man-made versions, called monoclonal antibodies, can be designed to attack a specific target, such as a substance on the surface of lymphocytes (the cells in which lymphomas start).
Several monoclonal antibodies are now being used to treat lymphoma. In some cases they may be used to help treat lymphoma of the eye.
Rituximab (Rituxan®) is an antibody that attaches to a substance called CD20 that is found on the surface of many lymphoma cells. This attachment seems to make the lymphoma cell die. Rituximab may be given by intravenous (IV) infusion or injected directly into the eye. The treatments can be given in the doctor’s office or clinic. Common side effects are usually mild but may include chills, fever, nausea, rashes, fatigue, and headaches. Even if these symptoms occur during the first rituximab infusion, it is very unusual for them to recur with later doses. Rituximab is often combined with chemotherapy.
The monoclonal antibody ibritumomab tiuxetan (Zevalin®) is similar to rituximab but has a radioactive molecule attached to it, which may help it work better. Because of the radiation, this drug is somewhat harder for doctors to give than rituximab. Another limitation is that it can’t be used along with chemo because it also lowers blood counts. At this time it is generally used if chemo and/or rituximab are no longer working.
Last Medical Review: December 9, 2014 Last Revised: February 5, 2016