Treatments for intraocular melanoma

Melanoma of the eye most often affects structures in the uvea of the eye, including the choroid, ciliary body or iris. This type of melanoma is called intraocular (uveal) melanoma. Treatment for intraocular melanoma depends on the location and size of the tumour in the eye and whether or not your vision can be saved. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. The following are treatment options for intraocular melanoma.

Radiation therapy is a main treatment for intraocular melanoma. It may be given as brachytherapy or external beam radiation therapy. Radiation therapy is sometimes given after surgery.

Surgery is sometimes used to treat intraocular melanoma. The types of surgery include:

• an eye resection to remove the tumour
• removal of the eyeball (called an enucleation)
• laser surgery (may be given as the main treatment or after another treatment)
• surgery to place a brachytherapy plaque over the eye tumour
• orbital exenteration to remove the eyeball, eyelid, muscles, nerves and fat if cancer has spread to the eye socket (orbit)

If intraocular melanoma spreads to the liver, surgery is sometimes used to remove the cancer in the liver (called a liver resection). Find out more about liver metastases.

Chemotherapy is sometimes used to treat advanced or recurrent intraocular melanoma that has spread to distant parts of the body (called metastatic eye cancer). It is usually given through a vein or in a pill taken by mouth and is called systemic chemotherapy.

Some doctors treat intraocular melanoma that has spread to the liver with chemotherapy delivered directly to the liver tumours through the main artery. This is done by hepatic artery infusion (also called chemoembolization).

Targeted therapy is sometimes used to treat advanced or recurrent intraocular melanoma. Targeted therapy drugs include:

• rituximab (Rituxan)
• ibritumomab (Zevalin)
• imatinib (Gleevec)
• sorafenib (Nexavar)

The following targeted therapy drugs may be used to treat vision problems related to radiation therapy:

• bevacizumab (Avastin)
• ranibizumab (Lucentis)

Immunotherapy helps to strengthen or restore the immune system's ability to fight cancer. The immunotherapy drug tebentafusp (Kimmtrak) may be used to treat unresectable or metastatic intraocular melanoma.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

A few clinical trials in Canada are open to people with intraocular melanoma. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.