Update on uveal melanoma: Translational research from biology to clinical practice (Review)

Int J Oncol. 2020 Dec;57(6):1262-1279. doi: 10.3892/ijo.2020.5140. Epub 2020 Oct 22.

Abstract

Uveal melanoma is the most common type of intraocular cancer with a low mean annual incidence of 5‑10 cases per million. Tumours are located in the choroid (90%), ciliary body (6%) or iris (4%) and of 85% are primary tumours. As in cutaneous melanoma, tumours arise in melanocytes; however, the characteristics of uveal melanoma differ, accounting for 3‑5% of melanocytic cancers. Among the numerous risk factors are age, sex, genetic and phenotypic predisposition, the work environment and dermatological conditions. Management is usually multidisciplinary, including several specialists such as ophthalmologists, oncologists and maxillofacial surgeons, who participate in the diagnosis, treatment and complex follow‑up of these patients, without excluding the management of the immense emotional burden. Clinically, uveal melanoma generates symptoms that depend as much on the affected ocular globe site as on the tumour size. The anatomopathological study of uveal melanoma has recently benefited from developments in molecular biology. In effect, disease classification or staging according to molecular profile is proving useful for the assessment of this type of tumour. Further, the improved knowledge of tumour biology is giving rise to a more targeted approach to diagnosis, prognosis and treatment development; for example, epigenetics driven by microRNAs as a target for disease control. In the present study, the main epidemiological, clinical, physiopathological and molecular features of this disease are reviewed, and the associations among all these factors are discussed.

Keywords: uveal melanoma; cell transduction pathways; epigenetics; miRNA; immunotherapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / antagonists & inhibitors*
  • Biomarkers, Tumor / metabolism
  • Chemoradiotherapy, Adjuvant / methods
  • Choroid / pathology
  • Ciliary Body / pathology
  • Clinical Trials as Topic
  • Epigenesis, Genetic / drug effects
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Incidence
  • Iris / pathology
  • Melanoma / diagnosis
  • Melanoma / epidemiology
  • Melanoma / etiology
  • Melanoma / therapy*
  • MicroRNAs / antagonists & inhibitors
  • MicroRNAs / metabolism
  • Molecular Targeted Therapy / methods
  • Neoadjuvant Therapy / methods
  • Ophthalmologic Surgical Procedures / methods*
  • Prognosis
  • Risk Factors
  • Uveal Neoplasms / diagnosis
  • Uveal Neoplasms / epidemiology
  • Uveal Neoplasms / etiology
  • Uveal Neoplasms / therapy*

Substances

  • Biomarkers, Tumor
  • MicroRNAs

Supplementary concepts

  • Uveal melanoma