Annual Review 2023

Improving eye cancer outcomes

A new clinical trial is aiming to protect vision and reduce the need for eye removal ahead of eye cancer treatment.

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CERA’s Ocular Oncology Research Unit is a leading collaborator in a global clinical trial to reduce the size of tumours in patients being treated for the eye cancer uveal melanoma.

Uveal melanoma is malignant eye cancer that develops in the middle layer of tissue found in the wall of the eyeball.

The rare cancer sometimes develops from a more common, benign eye lesion known as choroidal nevus – which affects about six per cent of the Australian population.

Current treatments for uveal melanoma require either removal of the eye or radiotherapy, which results in significant vision loss for more than half of patients.

Head of Ocular Oncology Research Dr Rod O’Day is leading CERA and the Royal Victorian Eye and Ear Hospital’s involvement in a new clinical trial, which offers a tablet therapy, darovasertib, to patients.

Dr O’Day says the trial has two aims: “We want to reduce the size of tumours that are very large, which would require enucleation – removal of the eye – so that they can be treated with an eye-conserving therapy instead, typically radiation.

“And for those who are already going to be treated with radiation, we want to reduce the dose of radiation used, to try to preserve the delicate structures in the eye and maintain as much vision as possible.”

Increasing patient access

CERA was a collaborator in an ongoing proof-of-concept trial of darovasertib, initiated by Professor Anthony Joshua at St Vincent’s Private Hospital in Sydney.

Collaborating with the Director of Oncology at Alfred Health Professor Mark Shackleton and his team, the Eye and Ear Hospital and CERA recruited six of the 15 patients to this initial trial.

The results of this study are yet to be published, but the manufacturer of darovasertib, IDEAYA Biosciences, launched an international clinical trial in November 2023.

“This is an important opportunity for our Victorian patients to have access to a new treatment that could potentially reduce the severity or the invasiveness of their treatment and improve outcomes,” says Dr O’Day.

Internationally, 80 patients will be recruited to the trial. CERA has worked closely with Professor Shackleton, and with Dr John McKenzie and Dr Daniel McKay at the Ocular Oncology Unit of the Eye and Ear Hospital to enrol three patients in the first few months.

Exploring liquid biopsies

In a separate study, Dr O’Day is also investigating whether it is possible to use fluid collected from the anterior chamber of the eye to improve the genetic analysis of uveal melanomas.

Current techniques gather melanoma cells from the tumours themselves, requiring an invasive surgical sampling technique.

“The prognosis for eye cancer patients is very much determined by the genetic makeup of the tumour cells, which have distinct signatures,” explains Dr O’Day.

“These signatures give very clear information about whether particular tumours are going to spread outside the eye.”

A liquid biopsy – collecting fluid from the eye’s anterior chamber – would provide a faster, safer, and more accessible test, as the fluid could be collected during the regular care of patients.

This research has received seed funding from the William Angliss Charitable Fund and will get underway in 2024, in collaboration with the Eye and Ear Hospital.


This story was originally published in People in focus: Annual Review 2023.

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