Cancer Medicine (Aug 2023)

Clinical features and prognosis of patients with metastatic ocular and orbital melanoma: A bi‐institutional study

  • Xin Liu,
  • Han Yue,
  • Shiyu Jiang,
  • Lin Kong,
  • Yu Xu,
  • Yong Chen,
  • Chunmeng Wang,
  • Yan Wang,
  • Xiaoli Zhu,
  • Yunyi Kong,
  • Xiaowei Zhang,
  • Jiang Qian,
  • Zhiguo Luo

DOI
https://doi.org/10.1002/cam4.6273
Journal volume & issue
Vol. 12, no. 15
pp. 16163 – 16172

Abstract

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Abstract Purpose Metastatic ocular and orbital melanomas are extremely rare. The clinical characteristics and standard treatments for these patients are not fully established. Materials and Methods We retrospectively analyzed patients with metastatic ocular and orbital melanoma from Fudan University Shanghai Cancer Center and Eye & ENT Hospital of Fudan University between January 2012 and May 2022. Results Overall, 51 patients with metastatic ocular and orbital melanoma were included. The most common primary sites were uvea (73%), followed by conjunctiva (22%), lacrimal sac (4%), and orbit (2%). Patients with uveal melanoma (UM) had a significantly younger age (48 vs. 68 years, p < 0.001), higher incidence of liver metastases (89% vs. 9%, p<0.001), a lower incidence of lymph nodes metastases (16% vs. 46%, p = 0.043) and a lower incidence of BRAF mutation (0% vs. 55%, p<0.001) compared with patients with conjunctival melanoma (CM). The overall response rate of the first‐line treatment was 18%. Three of the four patients with BRAF‐mutated CM responded to dabrafenib and trametinib treatment. The median progression‐free survival (PFS) and overall survival (OS) of first‐line treatment were 5.1 and 11.9 months, respectively. Among patients with liver metastases, liver‐directed treatment was correlated with better patient PFS (p < 0.001) and OS (p < 0.001) after adjusting for number of metastatic sites and primary sites. Conclusion CM and UM have different characteristics. Patient with CM had a high incidence of BRAF mutation, and the treatment of BRAF and MEK inhibitors conferred clinical benefit. Liver directed therapies had a potential benefit in disease control in patients with liver metastases.

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