[Therapy of metastatic malignant uveal melanoma].
The uvea is the most common site for extra-cutaneous melanoma and uveal melanoma is the most frequent primary intraocular tumour in adults. Because its different location, biology, histology, genetic features and prognosis in comparison to cutaneous melanoma, this tumour is considered as a distinct entity in the group of malignant melanoma. While primary uveal melanoma is usually treated by ophthalmologic oncologists, metastatic diseases is often managed by dermatologic oncologists. Hematogenous spread predominantly involves the liver and is often restricted to this organ for a long period. Metastatic uveal melanoma is usually resistant to chemotherapeutic regimens established for the therapy of cutaneous melanoma. Newer therapeutic modalities, such as local intra-arterial chemotherapy into the hepatic artery, perhaps combined with embolisation of feeder blood vessels of liver metastases, improves the prognosis of metastatic uveal melanoma. Currently the nitrosourea derivate fotemustine is the drug of choice in the local hepatic and systemic treatment and seems to be superior to other chemotherapeutic agents. Following the characterisation of primary uveal melanoma, we summarize the results of different treatment protocols for metastatic disease and give an overview of new strategies.
Jäckel
A
A
Universitäts-Hautklinik, Ruprecht-Karls-Universität Heidelberg, Vossstrasse 2, 69115 Heideberg. andreas_jaeckel@med.uni-heidelberg.de
Bock
M
M
Deichmann
M
M
Waldmann
V
V
Näher
H
H
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000628:therapy*; D009607:Nitrosourea Compounds / Q000627:therapeutic use; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D011379:Prognosis; D012878:Skin Neoplasms / Q000556:secondary / Q000628:therapy; D013997:Time Factors; D014604:Uveal Neoplasms / Q000401:mortality
D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; C054368:fotemustine