Universität zu Köln

Mor, J. M., Koch, K. R., Kakkassery, V., Cursiefen, C. and Heindl, L. M. (2019). New treatment options for iridociliary tumors. Ophthalmologe, 116 (4). S. 332 - 340. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

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Abstract

Background. Benign iridal tumors rarely necessitate a therapeutic intervention. In contrast, malignant tumors of the iris can threaten the patient's life and eyesight and require early treatment to prevent the development of metastases. Objective. Presentation of current treatment options for iridal tumors with special emphasis on iridal melanoma. Methods. This article gives an overview of the current literature based on a PubMed search as well as own clinical experience. Results. Treatment options for iridal and ciliary body melanomas comprise radiotherapeutic and surgical (eyeball-sparing and non-sparing) approaches. The eyeball-sparing surgical procedure of choice is block excision. While local tumor control rates and metastasis rates of block excision and radiotherapy are comparable, there are distinct differences especially between the spectra of complications. New treatment procedures include immunomodulatory approaches and targeted therapies. Using checkpoint inhibitors, no convincing enhancement of overall survival could be demonstrated for metastatic iridal melanoma, as is the case for cutaneous melanoma. In contrast, tumor vaccination with the help of tumor RNA-laden patient-derived dendritic cells seems to be a promising option for a subgroup of high-risk patients. Targeted therapies aiming to suppress the MAPK and PI3K/Akt pathways could not achieve any improvement in patient survival. Conclusion. For the primary treatment of iridal melanoma a surgical, eyeball-sparing approach and also when appropriate, radiotherapy can be recommended. In the future, eligible high-risk patients could profit from a tumor vaccination. To date, there is no effective systemic treatment for metastatic iridal melanoma.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mor, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, K. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kakkassery, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, L. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-151988
DOI:	10.1007/s00347-018-0825-7
Journal or Publication Title:	Ophthalmologe
Volume:	116
Number:	4
Page Range:	S. 332 - 340
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0423
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROTON-BEAM RADIOTHERAPY; RECURRENT IRIS MELANOMA; PLAQUE RADIOTHERAPY; UVEAL MELANOMA; BLOCK EXCISION; MANAGEMENT; THERAPY; METASTASIS Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15198