"Comprehensive Review of Current Approaches in the Management of Uveal Melanoma"

• Siddheshwar Wayse,  
• Pratap kulat,  
• Jahir Attar,  
• Vaibhav Wadge,  
• Ajay Bhagwat,  
• Rohit RAMESH Doke*

Abstract

Uveal melanoma (UM), the most common primary intraocular malignancy in adults, poses significant challenges due to its aggressive nature and potential for metastasis, particularly to the liver. This review provides a comprehensive overview of the current management strategies for uveal melanoma, encompassing diagnostic advancements, therapeutic modalities, and emerging approaches. Early detection remains pivotal, with imaging techniques playing a critical role. Standard treatments such as enucleation, radiotherapy (including plaque brachytherapy and proton beam therapy), and laser therapies aim to balance tumor control with vision preservation. The limitations of systemic therapies and the unique biology of UM have led to the exploration of targeted therapies and immunotherapies. Agents such as selumetinib, tebentafusp, and immune checkpoint inhibitors show promise but face challenges in efficacy and patient selection. Furthermore, adjuvant therapies and genetic profiling are shaping personalized medicine approaches, highlighting the importance of GNAQ, GNA11, and BAP1 mutations in prognosis and treatment decisions. This review also addresses the role of surveillance strategies in detecting metastases and improving overall outcomes. By integrating current evidence and clinical advancements, this article aims to provide insights into optimizing the management of uveal melanoma and identifying avenues for future research.

Keywords

Uveal melanoma, targeted therapy, immunotherapy, radiotherapy, genetic profiling, metastasis.