Growth of uveal melanoma following intravitreal bevacizumab Journal Article

Authors: Francis, J. H.; Kim, J.; Lin, A.; Folberg, R.; Iyer, S.; Abramson, D. H.
Article Title: Growth of uveal melanoma following intravitreal bevacizumab
Abstract: Purpose: Typically treatment of large melanomas (by Collaborative Ocular Melanoma Study criteria) is restricted to enucleation, due to size constraints for plaque brachytherapy. Because primary and metastatic uveal melanoma cells are inhibited by bevacizumab (an anti-vascular endothelial growth factor), this prospective study evaluated the impact of intravitreal bevacizumab on large uveal melanomas that were destined for enucleation. Size reduction by bevacizumab would potentially salvage these eyes by making them eligible for treatment with plaque brachytherapy. Procedures: Two patients with large uveal melanoma were each treated with one intravitreous injection of bevacizumab (1.25 mg/0.05 mL). Results: Both tumors displayed paradoxical growth 1 week following the injection, with confirmed growth 1 week later (increase from baseline of 1.1 mm in one eye and 3.1 mm in the other eye). Both eyes were enucleated and monosomy 3 and vasculogenic mimicry patterns were identified in both tumors. At 9 years follow-up, both patients were alive and metastasis free. Conclusion: These patients demonstrate that neoadjuvant intravitreous bevacizumab does not decrease the size of large uveal melanomas and may, in fact, result in their paradoxical growth. This observation supports a cautious approach in the use of intravitreous bevacizumab for uveal melanoma, particularly in the neoadjuvant setting. © 2016 S. Karger AG, Basel. All rights reserved.
Keywords: adult; human tissue; middle aged; case report; bevacizumab; drug efficacy; nuclear magnetic resonance imaging; outcome assessment; prospective study; tumor volume; echography; eye enucleation; uvea melanoma; monosomy; uveal melanoma; cancer; human; male; female; priority journal; article; intravitreal
Journal Title: Ocular Oncology and Pathology
Volume: 3
Issue: 2
ISSN: 2296-4681
Publisher: Karger  
Date Published: 2017-07-01
Start Page: 117
End Page: 121
Language: English
DOI: 10.1159/000450859
PROVIDER: scopus
PMCID: PMC5566762
PUBMED: 28868282
Notes: Article -- Export Date: 4 September 2018 -- Source: Scopus
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MSK Authors
  1. Jasmine Helen Francis
    97 Francis
  2. David H Abramson
    249 Abramson
  3. Saipriya   Iyer
    7 Iyer