What should be the first line treatment for metastatic uveal melanoma?

There is no consensus for frontline treatment of metastatic uveal melanoma. A clinical trial would be recommended for all patients if possible. If the disease is only within the liver, consideration of liver directed therapy would be reasonable. For metastatic disease beyond the liver checkpoint imm...

My first step is to check HLA-A*02:01. If matched, then tebentafusp is my clear first choice given the OS benefit in the randomized phase III study. If HLA is unmatched, then I look to see if liver-only disease vs extra-hepatic. If liver only, hepatic perfusion (aka Hepzato) is a good option. Can al...