Uveal Melanoma Study Shows High Efficacy Rates After RT/Vitrectomy Regimen

A recent study published in Cancers showed a disease metastasis-free survival rate of 80% at 5 years with an overall survival rate of 100% in patients with uveal melanoma treated with brachytherapy plaque with vitrectomy and silicone oil for radiation attenuation.1

Study author Tara A. McCannel, MD, PhD, highlighted how a keen observation from a colleague of hers led this single institution to investigate these results. Although this was a small sample size of only 37 patients, McCannel highlighted that the rates were different compared with historical data.

In an interview with CancerNetwork®, McCannel, director of the Ophthalmic Oncology Center at the University of California, Los Angeles (UCLA) Stein Eye Institute of the David Geffen School of Medicine at UCLA, delved more into the background of this study and the importance of continuing this research.

Transcript:

This was a unique study because we only examined a cohort of patients who live in Nevada. The origin of this study was that I have a medical oncologist colleague who monitors patients with ocular melanoma. One of the risks if you have uveal melanoma is that there is a potential risk of the cancer spreading in the body. In ocular melanoma, for reasons we don’t understand, the metastasis tends to occur in the liver, so these patients need to have scanning [or] imaging studies on a routine basis to monitor the liver and be sure that we’re always ahead of developing metastasis.

In the state of Nevada, my colleague—who’s a co-author of this paper, Wolfram Samlowski, MD, FACP—has been a wonderful resource who has seen all my patients over the past 15 years. I always recommend that patients see him because he knows about this cancer. He knows how to monitor people. He can counsel them and give them the follow-up that is important for this. Last year, he called me and just said, “Thank you for allowing me to look after your patients. I’ve learned so much about uveal melanoma…but there’s been 1 patient who died, and we’re not seeing metastasis in what’s published in the literature, what everybody knows with this cancer.” I was a little taken aback because I didn’t expect our rates of metastasis to be any different.

We decided to study this cohort. The other thing is that these patients are a stable population. These [patients] are being followed. They’re not moving. I find in our Los Angeles population, we have [patients] coming and going and lost to follow up, and we don’t know where they’ve gone. But this is a very stable population, so we looked at that, metastasis, and survival. That’s how we found our results were very different from what has been reported in the Collaborative Ocular Melanoma Study, which is the largest randomized prospective study of ocular melanoma; our mortality rates were different. In this cohort, we did what’s called Kaplan Meier estimate survival curves, and in terms of survival, our 5-year estimated survival was 100% in this cohort, whereas the Collaborative Ocular Melanoma Study for medium tumors had an overall survival of [about] 80%.2 The larger tumor group [showed about] 60% overall survival. Our numbers were very different.

This is a small study, and it’s a small sample. We don’t have hundreds of thousands of patients, but even in a small cohort, we were still surprised to see our results not fall in line or be close to what we know in the reported literature. For us, that is just a reason to study this further. We’re now looking at our current Los Angeles cohort and looking at all the patients that we’ve treated over time, and we’re excited to report numbers in the near future.

Reference

1. Rivas A, Samlowski W, McCannel TA. Unexpectedly low rate of metastasis and death among patients treated for uveal melanoma with brachytherapy, vitrectomy, and silicone oil. Cancers (Basel). 2025;17(16):2683. doi:10.3390/cancers17162683
2. Hawkins BS; Collaborative Ocular Melanoma Study Group. The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma: IV. Ten-year mortality findings and prognostic factors. COMS report number 24. Am J Ophthalmol. 2004;138(6):936-951. doi:10.1016/j.ajo.2004.07.006