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Procedure developed at UCLA helps identify deadly metastatic ocular melanoma

04/01/2007

Ocular melanoma is a sight- and life-threatening cancer. Although ocular melanoma is relatively rare — occurring in six patients per million — it carries a high risk of systemic spread, with half of those diagnosed developing incurable metastatic disease. While most melanomas respond well to local radiation therapy, the risk of metastasis remains even after treating the primary tumor. In addition, removal of the affected eye has not been shown to decrease the risk that the cancer will spread.

UCLA specialists have developed a technique to biopsy tissue from the eye and apply a genetic test to determine if the cancer is the highly aggressive type that is likely to spread. The technique uses an ultra-fine needle to penetrate the eye wall and collect cells from the tumor at the same time the cancer is being surgically treated with standard local radiation therapy. This procedure can reveal genetic information about the cancer and predict prognosis. Researchers hope that this will be the first step toward developing effective treatments to prevent and treat ocular melanoma.

Radiation therapy

Standard treatment for ocular melanoma delivers radiation to the tumor by suturing a radioactive plaque to the outside of the eye wall directly over the melanoma. The plaque, a disk of gold with radioactive seeds on the side facing the eye wall, is customized to the size of the tumor and stitched in place to irradiate the tumor. Once the desired amount of radiation has been delivered to treat the tumor, the plaque is removed.

Team approach

Patients treated at UCLA’s Ophthalmic Oncology Center benefit from a treatment team that brings expertise in retinal disease as well as ophthalmic oncology. Patients also consult with a radiation oncologist and physicist who help in the radiation plan and construction of the plaque. An ocular pathologist is on hand during the procedure, as is a research scientist, who processes material from the tumor that has been removed in the fine-needle aspiration biopsy.

Each ocular cancer patient at UCLA also meets with a health psychologist who is familiar with this cancer. The psychologist helps patients deal with the emotional aspects of their sight-threatening and life-threatening condition.

Focus on research

Only a handful of centers have the personnel and resources to go beyond offering the standard therapy for ocular melanoma. Research on ocular melanoma adds to the medical understanding of the condition and begins the search for new treatments that address the systemic threat of the disease and not just its ocular origin.

UCLA is engaged in a collaborative research effort that crosses specialties and scientific disciplines in an effort to characterize the genetic aberrations in these tumors and better predict which patients will experience metastatic spread. While currently no therapies exist to extend the lives of patients with the highly aggressive metastatic form of the disease, such prediction can allow physicians to monitor high-risk patients more closely. It can also help physicians and patients decide when to pursue experimental therapies that target metastasis.

Research at the Jules Stein Eye Institute at UCLA includes molecular and cytogenetic studies of tumor cells as well as banking tumor samples for future study.

Program physicians

Tara A.Young, M.D., Ph.D.
Assistant Professor of Ophthalmology
Co-director, Ophthalmic Oncology Center
Surgeon of Retina and Vitreous Disease
Jules Stein Eye Institute, UCLA

Bradley R. Straatsma, M.D.
Professor of Ophthalmology
Co-director, Ophthalmic Oncology Center
Jules Stein Eye Institute, UCLA

Patient referral

For more information, or to refer a patient, please use the numbers below.
(310) 206-7484 Voice
(310) 794-7904 Fax





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