Uveal melanoma treatments limited but advancing
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MONTEREY, Calif. — Progress is being made in the advancement of vision-sparing treatments for uveal melanoma, according to Alison Skalet, MD, PhD.
“Our primary treatments, which are enucleation and irradiation, are highly effective for intraocular tumor control,” Skalet said at the Women in Ophthalmology Summer Symposium, although globe-sparing therapy is associated with vision loss, usually from radiation retinopathy or optic neuropathy.
There are limited treatment options for metastatic disease, she said, but there are new therapeutics on the horizon.
AU-011 (belzupacap sarotalocan, Aura Biosciences) is a novel virus-like particle drug conjugate that induces cytotoxicity through photoactivation with near-infrared laser. In initial studies, AU-011 was administered intravitreally and was well tolerated, visual acuity was maintained in the majority of patients, and tumor control was “fairly good” at 12 months, she said.
In another trial that compared treatment with AU-011 with plaque brachytherapy, “As expected, there was a significantly higher proportion of subjects treated with plaque treatment that had worse vision than the patients treated with Aura, so it does look like it can preserve vision,” Skalet said.
A current trial is looking at suprachoroidal administration to optimize the delivery to the tumor and minimize the delivery of drug to the vitreous.
“This is still enrolling, but our initial data shows that there is a good safety profile. We’ve not had any cases of vitritis to date,” Skalet said.
Kimmtrak (tebentafusp, Immunocore) is a recently FDA-approved drug that is a bispecific soluble T-cell receptor therapeutic.
“It’s really exciting because it’s actually the first in class as a cancer therapeutic. It’s HLA-restricted but redirects T cells to proteins on cancer cells, in this case gp100-positive cells, and it’s been approved now for treatment of unresectable and metastatic uveal melanoma,” Skalet said.
There is room for improvement, Skalet said, “But we are making progress with this difficult disease.”
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Skalet A. Updates in melanoma treatment. Presented at: Women in Ophthalmology Summer Symposium; Aug. 25-28, 2022; Monterey, California (hybrid meeting).
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