Genetic Landscape and Emerging Therapies in Uveal Melanoma

Rino S Seedor, Marlana Orloff, Takami Sato, Rino S Seedor, Marlana Orloff, Takami Sato

Abstract

Despite successful treatment of primary uveal melanoma, up to 50% of patients will develop systemic metastasis. Metastatic disease portends a poor outcome, and no adjuvant or metastatic therapy has been FDA approved. The genetic landscape of uveal melanoma is unique, providing prognostic and potentially therapeutic insight. In this review, we discuss our current understanding of the molecular and cytogenetic mutations in uveal melanoma, and the importance of obtaining such information. Most of our knowledge is based on primary uveal melanoma and a better understanding of the mutational landscape in metastatic uveal melanoma is needed. Clinical trials targeting certain mutations such as GNAQ/GNA11, BAP1, and SF3B1 are ongoing and promising. We also discuss the role of liquid biopsies in uveal melanoma in this review.

Keywords: genetic landscape; metastatic uveal melanoma; targeted therapy; treatment strategy; uveal melanoma.

Conflict of interest statement

M.O. is a consultant for Immunocore and sits on the Scientific advisory board of Trisalus. R.S.S. and T.S. declare no conflict of interest.

Figures

Figure 1
Figure 1
Schema of TCGA UM Subtypes. Reprinted from “Molecular Characteristics of Uveal Melanoma: Insights from the Cancer Genome Atlas (TCGA) Project,” by Matheiu F. Bakhoum and Bita Esmaeli. 2019, Copyright 2019 by authors [28].
Figure 2
Figure 2
Signaling Pathways in UM. Adapted from “Targeted Therapy of Uveal Melanoma: Recent Failures and New Perspectives” by Michela Croce et al. 846 [121].

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