Novel Therapies for Choroidal Melanoma

Choroidal melanoma is a form of intraocular cancer that arises primarily from the choroidal tissues, occurring in an approximate 2500 people in North America and 7095 people worldwide each year. Historically, choroidal melanoma was treated by enucleation until the Collaborative Ocular Melanoma Study (COMS) demonstrated equal survival outcomes following radiation plaque therapy compared to enucleation for medium-sized tumors. Since then, most choroidal melanomas have been treated with radiation therapy, although some cases of large tumors, tumors with extrascleral extension, or tumors with low probability of vision retention may still call for enucleation. Nevertheless, although these two primary therapies have resulted in excellent local tumor control rates, they still can cause significant and devastating side effects in the years following treatment. However, researchers have recently developed virus-like particles (VLPs) that are able to target and kill tumor cells with high specificity after photoactivation. More specifically, the viral-like particle bioconjugate (VPB), AU-011, a VLP bioconjugated with a photosensitizer, is currently under investigation for the non-surgical treatment of choroidal melanoma in human clinical trials after encouraging in vitro and in vivo preclinical results. The use of intravitreal or suprachoroidal AU-011 holds great promise for the future of choroidal melanoma therapy with fewer visual side effects compared to current treatment standards.