Metastatic uveal melanoma is a rare cancer that can be hard to treat, but new medicines may help improve care for some people. Treatments can work by helping your immune system fight cancer, by directly targeting cancer cells or by combining with other approaches like surgery or radiation.  

Your care plan is personal, and your doctor will work with you to understand your options, track progress and adjust treatment as needed. 

Types of medicines 

There are several categories of medicines used to treat metastatic uveal melanoma: 

• Immune checkpoint inhibitors: These medicines help your immune system see and attack cancer cells. Sometimes they are given together for a stronger effect. Examples include nivolumab (Opdivo), pembrolizumab (Keytruda) and ipilimumab (Yervoy). 

• Tebentafusp (Kimmtrak): A targeted immune therapy that directs your immune system toward melanoma cells. Works only in people with a genetic marker called HLA-A*02:01 (your doctor will test for this). 

• Other targeted therapies and clinical trial medicines: These focus on blocking signals that help cancer grow. They are less common but may be an option in certain cases. 

How doctors choose a medicine 

The choice of medicine depends on many things. Your doctor will look at your overall health, your lab results and whether you have the HLA-A*02:01 marker. They will also think about your past treatments and how your cancer is changing. Sometimes the best plan is to start with one medicine, and later add or switch to another. 

Monitoring and follow-up 

When you start treatment, your doctor will schedule regular visits and blood tests. These help check how well the medicine is working and watch for side effects. You may also have scans, like CT or MRI, to see if the cancer is shrinking or staying the same. Follow-up is important so your care team can make changes if needed. 

Adjusting therapy over time 

Cancer treatment is not one-size-fits-all. If your cancer grows while on a medicine, or if side effects are too strong, your doctor may adjust the dose, pause treatment or change to another medicine. Sometimes medicines are combined for a stronger effect. Over time, your care plan may shift as your needs change. 

Working together with lifestyle changes 

Medicines are only one part of care. Eating healthy, staying active when possible, resting and managing stress can support your body during treatment. Your doctor may also recommend procedures like surgery or radiation to target specific tumors. These approaches often work best when used along with medicines. 

Precautions and safety 

It is important to know about possible risks and how to stay safe with treatment. Not everyone will have these problems, but some risks include: 

• Immune-related side effects: Immune checkpoint inhibitors like nivolumab (Opdivo), pembrolizumab (Keytruda) and ipilimumab (Yervoy) can sometimes make the immune system attack healthy organs instead of cancer. This may cause inflammation in the lungs, liver, intestines or hormone glands. Tebentafusp (Kimmtrak) can cause infusion reactions such as fever, chills or low blood pressure. 

• Pregnancy and organ health: Some treatments may not be safe during pregnancy or while breastfeeding. They may also be more risky if you have serious kidney, liver, lung or autoimmune conditions, since your body may not handle the medicine as well. 

• Drug interactions: Cancer medicines can interact with other prescription drugs, over-the-counter medicines and supplements. These interactions may reduce how well your treatment works or raise the chance of side effects. Always check with your doctor or pharmacist before starting anything new. 

• Other side effects: Common side effects include tiredness, skin rash, diarrhea, nausea or changes in lab results. Some side effects are mild and go away, while others may need quick medical attention. 

Always tell your care team about allergies, health conditions and all the medicines or supplements you take. It’s also important to take medicines exactly as prescribed. Skipping doses or stopping suddenly may reduce how well treatment works and could make the cancer harder to control. If cost, side effects or remembering doses is hard, talk to your doctor—there are often solutions.