Balance of innovation and safety needed when treating retinoblastoma
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KOLOA, Hawaii — Balancing innovation and safety is necessary in the field of retinoblastoma, according to a speaker here.
“It’s always important to remember that we are eye doctors, and these are children with a disease that, if untreated or inappropriately treated, can kill the child,” Jesse L. Berry, MD, said at Retina 2023. “The number one goal is to save the child’s life, and then their eye, then their vision.”
Retinoblastoma is the most common primary intraocular tumor in children, but it is rare, with only approximately 300 cases per year in the U.S., Berry said. It often presents with strabismus or leukocoria with an average age at diagnosis of 18 months.
“One of the questions that our parents ask and that we are asked in these sorts of pediatric retina sessions is, 'Is there an increased risk of metastatic disease if you give localized, intraarterial chemotherapy vs. systemic chemotherapy throughout the body?'” she said. “We still don't have a head-to-head trial to prove that.”
Current treatment options for retinoblastoma include enucleation, tumor consolidation, systemic chemoreduction vs. intraarterial chemotherapy and, rarely, external beam radiation.
“This is, thankfully, a rare tumor. It is a genetic disease that can occur either in the eye or throughout the body,” Berry said. “We have an improving prognosis for eye salvage, but we still have a ways to go. We really have to get this tumor into personalized medicine the same way the rest of oncology is.”
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Berry JL. Localized therapy for retinoblastoma: Where are we now and what is to come? Presented at: Retina 2023; Jan. 15-20, 2023; Koloa, Hawaii.
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