Advances in the therapeutic management of metastatic uveal melanoma including real-world experience with tebentafusp

Uveal melanoma is the most common malignant neoplasm of the eyeball. It develops from melanocytes of the uveal membrane of the eye, and it significantly differs from melanoma in terms of clinical behavior and therapy compared to other localizations. The survival of patients in metastatic settings is still poor and poses significant challenges.The most important factor determining the length of survival of these patients is the presence of metastases in the liver, which is the most common site of metastasis (70-90% of cases) and the only site in about 50% of cases. Survival from the point of finding metastatic lesions in the liver is usually short, with a median of a few months. In a systematic review of approximately 800 patients, overall survival (OS) in the group treated with systemic chemotherapy was 9 to 15 months compared to operated patients with survival of 10 to 35 months. For many years, studies testing systemic therapies have not yielded any positive results . The only exception is tebentafusp (IMCgp100), which is a new bispecific molecule targeting T cells in the presence of HLA-A*02:01. Currently, it is the only drug approved for systemic therapy of metastatic uveal melanoma with confirmed improvement in OS. In the present issue of Oncology of Clinical Practice, we present an international series of interesting case reports on using tebentafusp in clinical practice outside of clinical trials in patients with metastatic uveal melanoma.