Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5

Binder, Christina; Mruthyunjaya, Prithvi; Schefler, Amy C; Seider, Michael I.; Crilly, Richard J.; Hung, Arthur; Meltsner, Sheridan; Mowery, Yvonne M.; Kirsch, David G.; Teh, Bin S.; Jennelle, R.; Studenski, Matthew T.; Liu, Wu; Lee, Choonik; Hayman, James A.; Kastner, Brian; Hadsell, M; Skalet, Alison H.

doi:10.1159/000504312

Cited by 9 publications

(4 citation statements)

References 26 publications

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“…We therefore cannot draw conclusions about survival or the incidence of metastatic melanoma between patients treated with RAI and PBT. The literature, however, does not document a difference in survival or the likelihood of liver metastases from UM in patients treated with RAI 27 , 28 , 29 or PBT. 30 , 31 , 32 , 33 Also, one randomized clinical trial compared helium ion radiation to radioactive iodine implant 22 and found no significant difference in survival.…”

Section: Discussionmentioning

confidence: 93%

Treatment of Uveal Melanoma With Radioactive Iodine 125 Implant Compared With Proton Beam Radiotherapy

Bolling¹,

Dagan²,

Rutenberg³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Objective To review the current state of radiation therapy for uveal melanoma and compare particle radiation and brachytherapy. Patients and Methods The medical records of 156 patients treated for uveal melanoma between May 30, 2012, and March 16, 2020, were retrospectively reviewed. Treatments consisted of either radioactive iodine 125 implant (RAI) or fractionated proton radiation (proton beam therapy [PBT]). Baseline characteristics were compared using a Wilcoxon rank sum test or χ 2 test. Outcomes were compared using Cox proportional hazards regression models or logistic regression models. Results The median length of follow-up after treatment was 2.7 years (range, 0.5 to 9.0 years). Patients who underwent treatment with RAI were older (median age, 67 vs 59 years; P <.001) and had a lower tumor classification (American Joint Commission on Cancer; P=.001) compared with those who underwent PBT. There was no significant difference between RAI and PBT in the outcomes of liver metastases, death, enucleation, tearing, vision loss, retinal detachment, tumor thickness, conjunctivitis, optic neuropathy, iris neovascularization, or neovascular glaucoma (all P >.05). Patients who underwent RAI treatment had significantly higher risk of diplopia (P<.001), cataract progression (P<.001), and maculopathy (P=.03) compared with those who received PBT. Patients who underwent RAI were at higher risk of eyelash loss (P=.006) compared with the PBT group. Conclusion Treatment with PBT and RAI has similar efficacy; however, there are differences in the adverse outcomes associated with these 2 modalities.

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Section: Discussionmentioning

confidence: 93%

Treatment of Uveal Melanoma With Radioactive Iodine 125 Implant Compared With Proton Beam Radiotherapy

Bolling¹,

Dagan²,

Rutenberg³

et al. 2022

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…We suspect that the increased utilization of EPBT for large tumors is due to the advancements in EPBT technology, such as custom plaque designs, intra-operative optimization of plaque positioning using ultrasound, and developments in EPBT treatment planning systems [ 5 , 22 , 23 ]. The COMS trial evaluating EPBT excluded tumors of > 16 mm in basal diameter because the eye-plaques available at that time were not big enough to cover tumors larger than this.…”

Section: Discussionmentioning

confidence: 99%

Contemporary trends in management of uveal melanoma

Chevli¹,

Zuhour²,

Messer³

et al. 2022

jcb

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Purpose In the management of uveal melanoma, eye plaque brachytherapy (EPBT) has replaced enucleation as the standard of care for small size tumors that require treatment, and for medium size tumors. In the modern era, EPBT is being utilized more frequently for certain large tumors as well. While there is prospective randomized evidence to support utilization of EPBT for tumors of appropriate dimensions, it is unclear what the actual practice patterns are across the United States. The purpose of this publication was to look at contemporary trends in the management of uveal melanoma across the United States to determine whether practices are appropriately adopting EPBT, and to investigate demographic and socio-economic factors that might be associated with deviations from this standard of care. Material and methods The National Cancer Database was queried (2004-2015) for patients with uveal melanoma. Data regarding tumor characteristics and treatment were collected. Two-sided Pearson χ 2 test was used to compare categorical frequencies between patients who received globe preserving treatments vs. those who received enucleation. Multivariable logistic regression modeling was used to determine characteristics predictive for receiving enucleation. Results The enucleation rate for small/medium tumors (≤ 10 mm apical height and ≤ 16 mm basal diameter) decreased from 20% in 2004 to 10% in 2015. The EPBT rate for large tumors increased from 30% in 2004 to 45% in 2015. Numerous demographic and socio-economic factors were found to be associated with higher rates of enucleation. Conclusions The overall trend across the nation is a decreased enucleation rate for small/medium tumors, and an increased EPBT rate for large tumors. A fraction of patients who should be candidates for EPBT are instead receiving enucleation, and in this study, we have shown that certain adverse demographic factors are associated with this.

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“…Instead, methods such as brachytherapy (iodine-125, ruthenium-106, palladium-103, or cesium-131 plaque brachytherapy), proton beam radiotherapy, stereotac-tic irradiation or radiation surgery (LINAC, Gamma Knife, CyberKnife), transcleral local resection, transretinal resection, vitreoretinal (VR) surgery, and diode laser phototherapy have taken precedence. Radiotherapy, phototherapy, and local tumor resection are also often used in combination [5,[27][28][29][30]. Radiation therapy is currently the most used technique for the treatment of UM, with brachytherapy isotope plaques emitting gamma radiation being used in most ophthalmology centers [31,32].…”

Section: Current Therapy Of Ummentioning

confidence: 99%

From Molecular Biology to Novel Immunotherapies and Nanomedicine in Uveal Melanoma

Synoradzki,

Paduszyńska,

Solnik

et al. 2024

Current Oncology

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Molecular biology studies of uveal melanoma have resulted in the development of novel immunotherapy approaches including tebentafusp—a T cell–redirecting bispecific fusion protein. More biomarkers are currently being studied. As a result, combined immunotherapy is being developed as well as immunotherapy with bifunctional checkpoint inhibitory T cell engagers and natural killer cells. Current trials cover tumor-infiltrating lymphocytes (TIL), vaccination with IKKb-matured dendritic cells, or autologous dendritic cells loaded with autologous tumor RNA. Another potential approach to treat UM could be based on T cell receptor engineering rather than antibody modification. Immune-mobilizing monoclonal T cell receptors (TCR) against cancer, called ImmTAC TM molecules, represent such an approach. Moreover, nanomedicine, especially miRNA approaches, are promising for future trials. Finally, theranostic radiopharmaceuticals enabling diagnosis and therapy with the same molecule bring hope to this research.

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Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5

Cited by 9 publications

References 26 publications

Treatment of Uveal Melanoma With Radioactive Iodine 125 Implant Compared With Proton Beam Radiotherapy

Treatment of Uveal Melanoma With Radioactive Iodine 125 Implant Compared With Proton Beam Radiotherapy

Contemporary trends in management of uveal melanoma

From Molecular Biology to Novel Immunotherapies and Nanomedicine in Uveal Melanoma

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