Metastatic Uveal Melanoma When HLA-A*02:01 Is Absent in Peripheral Blood

Clinical scenario

This protocol addresses patients with metastatic uveal melanoma in whom the HLA-A*02:01 allele is absent in peripheral blood. The absence of this allele defines a subgroup for which standard-of-care options differ from HLA-A*02:01-positive disease, and treatment selection depends on local resources and individual tumour burden.

Approach overview

For HLA-A*02:01-negative patients, liver-directed approaches and immune-based therapies represent the preferred strategies — with the specific option depending on resources and patient factors. Clinical trial enrolment is also strongly recommended in this setting.

The full protocol specifies which modalities apply, the sequencing considerations, and the criteria that guide selection — see the complete regimen below.

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References

DOI: 10.1016/j.esmoop.2026.106888

For HLA-A*02:01-negative patients, in the absence of a standard of care and depending on local resources, liver-directed therapies (PHP and IHP), anti-PD-1-based immunotherapies and clinical trial enrolment are the preferred therapeutic options [V, B].

The melphalan for Injection/Hepatic Delivery System, recently approved by the Food and Drug Administration (FDA), may be considered an option in patients with HLA-A*02:01-negative UMLMs and limited tumour burden.

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