Uveal melanoma guidelines

Uveal melanoma is a very rare form of the disease, which is managed differently from other melanomas. Comprehensive guidance on this subject was developed for the first time in 2015. This guideline was developed by a leading clinical and research specialist interdisciplinary group with patient input. While much of the guideline is still current, the 2022 guidelines updated the following sections:

  • molecular pathology and features
  • prognostic markers
  • loco-regional management of hepatic predominant disease
  • management of metastatic disease
  • adjuvant radiation therapy
  • support of patients

Uveal melanoma is a very rare form of the disease, it requires different clinical management from other melanomas

Uveal Melanoma Guidelines

We are extremely grateful to Professor Paul Nathan, Trustee (consultant medical oncologist, Mount Vernon Cancer Centre) for chairing the guidelines development group (GDG) which formed in 2020 to review the 2015 guidelines. The group from fields of medical oncology, clinical oncology, radiology, pathology, uveal melanoma science and patient representation with project management and methodological support provided by Mrs Nancy Turnbull, the Project Manager.

Follow the individual links below for the relevant guidelines:

uveal diagram

Following the completion of the Uveal melanoma guidelines, Professor Paul Nathan stated:

“The Uveal Melanoma National Guidelines have recommended standards of care for all of our patients across the UK. These updated guidelines include recent advances in our understanding of the distinct biology of this disease, assess the evidence for recent improvements in care and have a renewed focus on patient experience. We believe they will continue to be an important reference document for patients, their supporters and clinicians.  I would like to particularly thank Nancy Turnbull for facilitating the process and my colleagues on the guidelines committee who have given so much of their time and expertise to this worthwhile effort. Furthermore, these updated guidelines wouldn’t have materialised without the funding from Melanoma Focus who received a welcome donation from OcuMel UK”.

Update of Metastatic Surveillance of Uveal Melanoma

Melanoma Focus have set up a Guideline Development Group (GDG) to update the metastatic surveillance of Uveal Melanoma guideline which was originally published in 2015. This work commenced in September 2022 and the consultation will be open until 1st June 2023.

The Guideline Development Group (GDG) will be led by Dr Matthew Wheater, with project management and methodological support by Nancy Turnbull and funding by Melanoma Focus.

The Guideline Development Group consists of:

  • Dr Matthew Wheater, Medical Oncologist
  • Mrs Nancy Turnbull, Project Manager
  • Professor Sarah Coupland, Histopathologist
  • Professor Bertil Damato, Ophthalmologist
  • Mr Stephen Fenwick, Hepatobiliary surgeon
  • Dr Leila Khoja, Medical Oncologist
  • Dr Sachin Modi, Interventional Radiologist
  • Mr Guy Negretti, Ophthalmologist
  • Dr Heather Shaw, Medical Oncologist
  • Ms Reta Sowton, Oncology Nurse
  • Ms Helen Evans, Patient Representative
  • Ms Tracey Krausa, Patient Representative

Consultation- Uveal melanoma surveillance update

The chair of the uveal surveillance update, Dr Matthew Wheater, invites you to comment on the guidance and executive summary.

The final guideline will be included in the 2022 Uveal Melanoma Update available on the Melanoma Focus website.

When making comments please remember that this guidance addresses surveillance only. No changes can be made to the rest of the guidance at this time as it has been signed off and published. The full guidelines will next be reviewed in five years’ time as per methodology agreed with NICE.

Draft Executive Summary- We are particularly interested in your views on the recommendations in this document. If, for example, you think the evidence has been misinterpreted or if higher quality evidence has been overlooked please note this on the Comments table. In the absence of evidence, recommendations were made after debate by the Guideline Development Group (GDG) and we would welcome your views on these.

Draft Full Guidance-The available evidence has been searched and reviewed. The evidence reviews and the decisions made by the GDG which underpin the recommendations are detailed in the full document. The full guideline also contains the recommendations, -please comment on them only once. Changes made to recommendations in either document will be reflected in the other.

Draft Appendix- contain more detailed tables and supporting information.

Comments table-Please put your name on the table and put all of your comments into this table noting page number and recommendation number. We do not have the resources to deal with comments received in any other format.

How to comment

Please use document 5 the comments table for all your comments. For each comment put the page number in the first column and either the recommendation number, for the executive summary, or the line number in the second column. This is very important.

Page 1 is for comments on document 1 – the Executive Summary
Page 2 for comments on document 2 – the full guideline
Page 3 for comments on the Appendix

Please add extra lines and pages as needed.

The recommendations are in both document 1 or 2, please comment in one or the other, there is no need to comment in both.

We would be grateful if you would return the Comments table as soon as possible by 1st June at the latest to the Nancy Turnbull, the Project Manager, at om.guideline@gmail.com

We would like comments from a wide range of people with experience of this condition, as a patient/carer, support group or as a clinician, and would be grateful if you would forward this email to anyone who you think may be interested.

Please Note: In the interests of transparency, comments are not anonymous. Names will be published with the comments and the Development Group response on the Melanoma Focus Website at the time of publication of the guideline. We will ask for declarations of interest from all reviewers.

Thank you for your interest and help. Your contribution will be acknowledged in the guideline.

Essential Ocular Oncology: A Guide for Practitioners

Professor Bertil Damato has provided password protected access to Essential Ocular Oncology: A Guide for Practitioners.

This has been password protected as the pictures of patients used in this guideline were collected over the past 22 years and during this time a proportion of the patients have died, this has meant that the authors of the guide have been unable to obtain consent to show the patients pictures in the public domain. Therefore, this guide can only be used for professional teaching purposes.

Click here to access the password protected document.

Research invitation: Development of a quality of life questionnaire for people with metastatic uveal melanoma

Medical oncologist Prof Anthony Joshua and collaborators at the University of Technology Sydney (UTS) are conducting a study to develop a questionnaire for measuring impacts on quality of life from metastatic uveal melanoma and its treatment for use in future clinical trials.

Participation will involve a 30-minute interview or focus group in which you will be asked about the impacts on quality of life you have observed from metastatic uveal melanoma and its treatment.

Clinicians from all disciplines – medical, nursing and allied health – are invited to participate.

Interviews/Focus groups can be conducted either face to face or via Zoom.

If you would like further information, please contact the co-ordinating investigator, Dr Tim Luckett, via tim.luckett@uts.edu.au

This study has been approved by the St Vincent’s Hospital Human Research Ethics

CURE OM Patient VISION Registry

This international registry is funded and sponsored by the Melanoma Research Foundation’s CURE  OM initiative. The patient-reported ocular melanoma registry is an online database that securely collects, stores, monitors, analyses and shares data for research purposes. Open to patients and caregivers, registration is required and several personalised surveys to document diagnosis and treatment are requested. Participants can save their progress and continue the surveys at a future time and can revisit their records to update any changes.

Please share this link with your patients: https://melanoma.org/visionregistry/

COPYRIGHT NOTICE: ALL documents are Copyright © 2018 & 2020 Melanoma Focus. Permission is granted to reproduce them, with attribution to Melanoma Focus, for personal clinical and educational use only. Commercial copying or lending is prohibited.

Further resources

Nathan P, et al. Uveal Melanoma Guideline Development Working Group. Uveal Melanoma UK National Guidelines. Eur J Cancer. 2015 Nov;51(16):2404-12. doi: 10.1016/j.ejca.2015.07.013. Epub 2015 Aug 13. PMID: 26278648.
The full text PDF publication is available to download here

NB: These Guidelines were developed in accordance with the Melanoma Focus Guideline Development Methodology Manual. The methods have been accredited by NICE as complying with their AGREE II criteria for the rigorous development of evidence-based guidelines.
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