Treating advanced eye cancer (ocular melanoma)
The treatment you have depends on where the eye melanoma has spread to and the treatments you have already had. If the melanoma comes back in the eye, it is called local recurrence.
About treatment for advanced eye cancer (ocular melanoma)
The treatment you have depends on where the eye melanoma has spread to and the treatments you have already had.
If the melanoma comes back in the eye, it is called local recurrence. This usually needs to be treated with surgery to remove the eye.
Chemotherapy into a vein is not often used to treat advanced eye melanoma. But sometimes you may have a drug called paclitaxel.
Treatment will also depends on the type of eye melanoma you have.
Conjunctival melanoma
Conjunctival melanoma sometimes spreads to the lymph nodes close to the eye. If this happens, you may have surgery to remove the lymph nodes in the neck. This helps to control the melanoma.
Sometimes targeted therapy drugs may be used to treat advanced conjunctival melanoma.
Uveal melanoma
If uveal melanoma comes back in the liver, you can have different treatments.
An immunotherapy drug called tebentafusp or Kimmtrack® may be used to control uveal melanoma and help people live for longer.
Treatments directly to the liver
If uveal melanoma spreads, it usually goes to the liver. This is called secondary liver cancer. Doctors may find secondary liver cancer during regular tests to check your liver. If the cancer is only in the liver, different treatments can be used.
These include:
- a type of surgery called liver resection – if there is only 1 tumour or a few tumours
- radiofrequency ablation
- injecting chemotherapy drugs or other substances into the liver to destroy the cancer cells or cut off their blood supply (called chemoembolisation).
Immunotherapy drugs for advanced eye cancer
Immunotherapy drugs help the immune system to find and attack cancer cells.
Nivolumab and ipilumumab are immunotherapy drugs you may have to help control advanced eye melanoma. You usually have them together or sometimes on their own. You have them as a drip into a vein.
Tebentafusp (Kimmtrak®)
Tebentafusp is a newer immunotherapy drug that controls uveal melanoma and helps people to live for longer. Doctors expect it to become standard care for people with advanced uveal melanoma. The National Institute for Health and Care Excellence (NICE) is still reviewing tebentafusp. Your doctor can tell you more about this treatment.
You usually have tebentafusp by injection into a vein once a week. Your doctor and nurse will talk to you about the possible side effects and what to expect.
The first 3 treatments may cause a reaction, so you need to stay in hospital to have them. Doctors and nurses will monitor you for several hours afterwards.
Targeted drugs for advanced conjunctival melanoma
Targeted therapy drugs target something in or around the cancer that is helping it to grow. Drugs that target certain genetic changes found in skin melanoma are sometimes used to treat conjunctival melanoma. But this is not standard treatment. Your doctor can tell you if a targeted drug may be suitable for you.
Targeted therapy drugs are not used to treat uveal melanoma.
About our information
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References
Below is a sample of the sources used in our eye cancer (ocular melanoma) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Jain P, Finger PT, Fili M, et al. Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study. British Journal of Ophthalmology 2021;105:1358–1364. (accessed May 2022).
Nathan, Paul, Hassel, Jessica C, et al. Overall Survival Benefit with Tebentafusp in Metastatic Uveal Melanoma. New England Journal of Medicine, 2021, 385(13):1196-1206. (accessed May 2022).
Jessica Yang, Daniel K. Manson, et al. Treatment of uveal melanoma: where are we now? Therapeutic Advances in Medical Oncology. 2018, Vol. 10: 1–17. (accessed May 2022).
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Samra Turajlic, Consultant Medical Oncologist.
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