Systemic Treatments Although there are currently no FDA-approved systemic treatments for metastatic uveal melanoma, some clinicians recommend treatment with therapies that have been FDA-approved for cutaneous melanoma. In addition, ongoing clinical trials may give patients access to systemic agents before they are approved. • Immunotherapy A type of systemic treatment given to activate a person’s immune system so that it will destroy melanoma cells within the body. Several immunotherapies are FDA-approved for cutaneous melanoma and some are being studied in uveal melanoma. However, success with these treatments in UM has been limited so far. Clinical trials are currently underway to better understand immunotherapies in UM. • Targeted Therapy A form of treatment in which drugs are developed with the goal of destroying cancer cells while leaving normal cells intact. These drugs are designed to interfere with the specific molecules, genetic mutations in the tumor itself, that are driving the growth and spread of the tumor. Common mutations in cutaneous melanoma (such as BRAF) are not often found in UM. The most common mutations in uveal melanoma are the GNAQ, GNA11 and BAP1 genes. Clinical trials are currently underway to better understand these mutations and possible treatment options. • Chemotherapy Overall, chemotherapy has not been shown to be effective for uveal melanoma. However, it may still be recommended in some cases. Clinical Trials • Trials help physicians determine which patients should receive which drugs in which order (sequence). • Trials may provide you access to therapies not yet approved by the FDA but that may be more effective. • Trials are usually (but not always) free to participate in and you may have more diagnostic tests while participating than you otherwise would have during regular treatment. Be sure you understand your health insurance policy and the coverage of the clinical trial so you are fully aware of what is covered and what is not. There is some important information you should know about clinical trials in uveal melanoma:
Managing Side Effects Unfortunately, side effects are a reality of every treatment option. Side effects vary by treatment and by individual. Some patients experience every possible side effect while others experience very few, and sometimes no side effects from their treatment. Common side effects of certain immunotherapy and targeted therapy melanoma treatments include, but are not limited to:
• Diarrhea • Vitiligo (loss of pigment) • Skin rash
• Lymphedema • Thyroid issues • Colitis
• Itching • Fever • Fatigue
• Nausea • Constipation • Joint pain
Be sure to talk to your doctor about all side effects that you experience as soon as you begin experiencing them. This will allow your treatment team to manage the side effects more effectively.
TIPS TO REMEMBER
1 Never hesitate to mention your side effects to your treatment team. Keeping your treatment team informed of all side effects as soon as they occur is of the utmost importance. 2 Experiencing few or no side effects does not mean the treatment isn’t working. 3 It’s impossible to know how you will react to any given treatment. 4 There is no one-size-fits-all treatment for ocular melanoma — everyone’s case is different.
• You can choose to stop participating in a trial at any time.
Visit www.melanoma.org/clinical-trials to explore a database of clinical trials that may be right for you.
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