Uveal melanoma is a type of cancer that affects the eye and is distinct from the more common cutaneous melanoma that affects the skin. It is a rare but aggressive cancer with a low tumor mutational burden and a 1-year overall survival rate of about 50% in patients with metastatic uveal melanoma. This means that about half of patients with this type of cancer survive for at least one year after diagnosis.
However, a recent clinical trial has shown that a new treatment called tebentafusp may improve survival rates in patients with metastatic uveal melanoma. Tebentafusp is a bispecific fusion protein that works by redirecting T cells to attack cancer cells expressing the gp100 protein, which is found on melanoma cells.
In the clinical trial, patients with previously untreated metastatic uveal melanoma were randomly assigned to receive either tebentafusp or the investigator’s choice of existing therapies, including pembrolizumab, ipilimumab, or dacarbazine. The results showed that overall survival at 1 year was significantly higher in the tebentafusp group (73%) compared to the control group (59%). In addition, progression-free survival, or the length of time during which the cancer does not get worse, was also significantly higher in the tebentafusp group (31% at 6 months) compared to the control group (19% at 6 months).
The most common side effects reported in the tebentafusp group were cytokine-mediated events and skin-related events, including rash, fever, and itching. These side effects decreased in incidence and severity after the first few doses and did not frequently lead to treatment discontinuation. No treatment-related deaths were reported.
Tebentafusp is only effective in patients who express the HLA-A*02:01 protein, which is found on the surface of many cells in the body and plays a role in the immune response. This protein is more common in White patients and is present in about 50% of White patients with uveal melanoma.
Overall, the results of this clinical trial suggest that tebentafusp is a promising new treatment for patients with metastatic uveal melanoma, improving both overall survival and progression- free survival. In addition, there is soon to come clinical trial using tebentafusp in combination with checkpoint inhibitors for advanced cutaneous melanoma.
The Orlando Health Cancer Institute is proud to offer this unique form of treatment to our patients with metastatic uveal melanoma. If you or a loved one has been diagnosed with this type of cancer, we encourage you to speak with your healthcare provider about the potential benefits of tebentafusp and whether it may be right for you.
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. Currently practicing at the renowned Orlando Health Cancer Institute, he brings a wealth of expertise to the complex and challenging world of oncology.
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