Metastatic disease
Metastatic uveal melanoma: where the decision starts
After metastases are found, the algorithm starts with clinical, anatomical and biomarker assessment - not with a drug name.
For patients and clinicians
First decision nodes
HLA-A*02:01
Treatment-defining biomarker for tebentafusp.
Anatomy
Liver-only/liver-dominant/extrahepatic disease, burden and technical feasibility.
Tempo
ECOG, LDH, symptoms, pace and patient goals.
Systemic therapy, liver-directed treatment and trials may occupy different positions depending on the scenario.
Key references
- Piperno-Neumann S, et al. ESMO-EURACAN Clinical Practice Guideline. ESMO Open. 2026.
- Hassel JC, et al. Three-year overall survival with tebentafusp. N Engl J Med. 2023.
- Pelster MS, et al. Nivolumab + ipilimumab in metastatic UM. J Clin Oncol. 2021.
- FDA. Melphalan/Hepatic Delivery System for hepatic metastases from uveal melanoma. 2023.