this may not be good news--but it may turn out to be very useful information advising caution with avastin shots in the eye in those with ocular melanoma:
this was done in mice and in petri dishes, but points out the theoretical risk if any melanoma cells are left
I also listed articles on both intracameral/intraocular and systemic avastin's effects on radiation induced injury to the eye--several done on those receiving proton therapy, one even on micromets to the liver.
SO it should be possible for you to use entrez pub med to research based on intraocular vs systemic avastin and perhaps ask if they think they got every cell and if the avastin is preventative to protect your vision from the longterm effects of the radiation or to prevent recurrence/mets.
I have not yet looked up clinical trials but can give you the names my friend listed as knowing who might be best to consult. You are not so far from the NIH-- I have not yet identified who the NIH's ocular melanoma expert(s) is/are.
names: I think Sapna Patel or Scott Woodman at MDAnderson might know, also Rich Carvajal at MSKCC
MEK inibitors are being tried and there is a theoretical reason to try gamma secretase inhibitors. Now to look up trials...
Mol Vis. 2012;18:2454-67. Epub 2012 Oct 5.
Bevacizumab and intraocular tumors: an intriguing paradox.
el Filali M, Ly LV, Luyten GP, Versluis M, Grossniklaus HE, van der Velden PA, Jager MJ.
Source
Department of Ophthalmology, LUMC, Leiden, the Netherlands.
m.el_filali@lumc.nl
Abstract
PURPOSE:
Bevacizumab, a humanized monoclonal antibody to vascular endothelial growth factor-A (VEGF-A), was originally developed as an anti-tumor treatment. In ocular oncology, it is being used to treat macular edema due to radiation retinopathy, but it may also be useful for the treatment of primary uveal melanoma (UM) or its metastases. We determined the effect of bevacizumab on the growth of B16F10 cells inside the eye and on B16F10 and UM cells cultured in vitro.
METHODS:
B16F10 melanoma cells were placed into the anterior chamber of the eye of C57Bl/6 mice and tumor growth was monitored after injection of different doses of bevacizumab or mock injection. In addition, the effect of bevacizumab on in vitro growth of B16F10 and human UM cells and on the expression of VEGF-A, GLUT-1, and HIF-1α was evaluated.
RESULTS:
Following intraocular injection of bevacizumab into murine B16 tumor-containing eyes, an acceleration of tumor growth was observed, with the occurrence of anterior chamber hemorrhages. Bevacizumab did not affect proliferation of B16F10 cells in vitro, while it inhibited UM cell proliferation. Expression analysis demonstrated that addition of bevacizumab under hypoxic conditions induced VEGF-A, GLUT-1 and HIF-1α in B16F10 cells as well as in UM cell lines and two of four primary UM tumor cultures.
CONCLUSIONS:
In contrast with expectations, intraocular injection of bevacizumab stimulated B16F10 melanoma growth in murine eyes. In vitro exposure of B16 and human UM cells to bevacizumab led to paradoxical VEGF-A upregulation. The use of VEGF inhibitors for treatment of macular edema (due to radiation retinopathy) after irradiation of UM should be considered carefully, because of the possible adverse effects on residual UM cells.
PMID: 23077404 [PubMed - indexed for MEDLINE] PMCID: PMC3472924 Free PMC Article
entrez pubmed---
Bevacizumab and intraocular tumors: an intriguing paradox.
el Filali M, Ly LV, Luyten GP, Versluis M, Grossniklaus HE, van der Velden PA, Jager MJ.
Mol Vis. 2012;18:2454-67. Epub 2012 Oct 5.
PMID: 23077404 [PubMed - indexed for MEDLINE] Free PMC Article
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New therapeutic agents in uveal melanoma.
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[Intraocular bevacizumab as palliative therapy in melanoma-metastasis-associated rubeotic secondary glaucoma].
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