[Uveal melanoma : Early detection as the key to successful personalized medicine]

Ophthalmologe. 2020 Jun;117(6):508-520. doi: 10.1007/s00347-019-01001-8.
[Article in German]

Abstract

Background: Personalized medicine in the oncological care of patients aims to ensure the best possible outcome for patients by tailoring the diagnostics and treatment to the individual. This goal also applies to patients with uveal melanoma (UM).

Objective: The aim of this article is to define the present and future potential of personalized medicine and maximize its benefits in patients with UM.

Methods: This article gives an overview of current theranostics for UM and describes a recent paradigm shift in diagnostics and the potential impact of new therapeutic developments.

Results: Treatment is initiated when the diagnosis of UM is histologically confirmed or is very probable based on clinical characteristics. Current treatment concepts are primarily influenced by various factors, such as the anatomical features of the primary tumor, situation of the contralateral eye and also the age, health status and wishes of the patient. The current treatment and control of the primary tumor are very successful but they have little influence on the development of metastases and life expectation. The life expectation of the patient essentially depends on the timing of the diagnosis and treatment of the UM. The liquid biopsy is a new diagnostic tool that supports an early decision for a more invasive diagnostic procedure or treatment. Molecular biological techniques enable a risk stratification and provide a foundation for decision making for neoadjuvant forms of treatment.

Conclusion: The present concept of personalized medicine for UM is restricted to the treatment of the primary tumor. New diagnostic options, such as liquid biopsy and molecular genetic investigations help to acquire a better understanding of the mechanisms involved and provide the foundation for precision medicine in the development of further personalized treatment concepts.

Keywords: Diagnosis; Liquid biopsy; Personalized medicine; Treatment; Uveal melanoma.

Publication types

  • Review

MeSH terms

  • Early Diagnosis
  • Humans
  • Melanoma / drug therapy*
  • Precision Medicine
  • Uveal Neoplasms / drug therapy*

Supplementary concepts

  • Uveal melanoma