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A New Look at a Rare Eye Cancer Treatment

For the first time, a treatment has been identified that may shrink advanced uveal melanoma.  Uveal melanoma is an eye cancer in which tumors arise from pigment cells inside the uvea, which gives the eye color.  Treatments to date have ranged from radiation therapies, surgical resection, to removing the eye in extreme cases.  While all of these treatments have been ways to deal with the tumor, the novel kinase inhibitor selumetinib is the first treatment to actually shrink the melanoma.
This treatment was developed when researchers realized the majority of patients with uveal melanoma have genetic mutations in Gnazq or Gna11 that activate cancer cell growth.  MEK, the combination of MAP and ERK, is a chain of proteins that can cause cancer when one of the proteins in the cell is mutated.  Selumetinib inhibits MEK and reduces growth. 
In a recent study, half the patients taking selumetinib experienced a reduction in tumor size compared to those taking the standard chemotherapy temozolomide.  They also had a higher percentage of reduction in tumor volume and progression-free survival.  
Michael Atkins, MD, a melanoma specialist and deputy director of Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C. described the significance of this discovery in MedPage Today, “This is the first time any systemic therapy has been shown to work in patients with ocular melanoma.  This disease has been viewed as practically untreatable until now.”  He went on to say that it not only expands possibilities for treating uveal melanoma patients, but also testing MEK inhibitors.
Selumetinib may also be used to treat thyroid and lung cancer, and may be introduced as a commercial treatment option.  This will be determined based on identifying the population who will benefit from it.  
Sources: 1, 2, 3
[image by Martin Sojka]

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