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Oh AJ, McCannel CA, McCannel TA. Brachytherapy Plaque Removal in Office. Am J Ophthalmol 2024; 261:e3-e4. [PMID: 38431138 DOI: 10.1016/j.ajo.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Angela J Oh
- From the Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
| | - Colin A McCannel
- From the Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
| | - Tara A McCannel
- From the Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States.
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Hoch MM, MacDonald JJ, Jorge-Miller A, McCannel TA, Beran TM, Stanton AL. Depression in Uveal Melanoma Survivorship: Examining Psychological Predictors of Adjustment in the First Year Following Diagnosis. Ann Behav Med 2023; 57:1081-1096. [PMID: 37874742 DOI: 10.1093/abm/kaad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND A rare cancer, uveal melanoma (UM) affects 5 in 1 million adults annually. Research on predictors of mental health in UM survivors is scarce. PURPOSE In this prospective study, we tested models that postulate interactions between illness perceptions and coping processes in predicting depressive symptoms 1 year following UM diagnosis. METHODS Participants' approach- and avoidance-oriented coping processes and illness perceptions specific to control and chronicity were assessed. Participants (N = 107) completed assessments prior to diagnosis (T0), and 1 week (T1), 3 months (T2), and 12 months after UM diagnosis (T3). RESULTS At T1, a significant avoidance coping × chronicity perception interaction (b = 1.84, p = .03) indicated that the link between higher avoidance coping and greater T3 depressive symptoms was stronger for participants with prolonged chronicity perceptions (b = 17.13, p < .001). Chronicity perceptions at T2 interacted significantly with approach-oriented coping at all time points; the link between higher approach coping and lower T3 depressive symptoms was stronger for participants with prolonged chronicity perceptions at T2. Interactions between control perceptions and coping did not significantly predict T3 depressive symptoms. CONCLUSIONS Findings lend partial support to predictive models that consider the combined, interacting influence of chronicity perceptions and coping processes on depressive symptoms in survivors of eye cancer.
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Affiliation(s)
- Megan M Hoch
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - James J MacDonald
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Tara A McCannel
- Department of Ophthalmology, Retina Division and Ocular Oncology Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tammy M Beran
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
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Bonnet C, Chehaibou I, McCannel CA, McCannel TA, Prasad PS, Kreiger AE, Schwartz SD, Aldave A, Hubschman JP. Reply. Retina 2023; 43:e31-e32. [PMID: 36763983 DOI: 10.1097/iae.0000000000003757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- Clémence Bonnet
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
- Ophthalmology Department, Hôpital Cochin, AP-HP and Université Paris Cité, France
| | - Ismael Chehaibou
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
- Retina Department, Rothschild Foundation, Université de Paris Cité, Paris, France
| | - Colin A McCannel
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Tara A McCannel
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Pradeep S Prasad
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Allan E Kreiger
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Steven D Schwartz
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Anthony Aldave
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Jean-Pierre Hubschman
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
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Mustak H, Lo C, Cohen LM, Tran A, Almanzor R, McCannel TA, Goldberg RA, Rootman DB. Extrascleral extension of choroidal melanoma after iodine-125 brachytherapy treatment: a case series. Eye (Lond) 2023; 37:249-255. [PMID: 34987200 PMCID: PMC9873620 DOI: 10.1038/s41433-021-01861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/15/2021] [Accepted: 11/12/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND/OBJECTIVES The purpose of this study is to report cases of choroidal melanoma that developed extrascleral tumour recurrence after treatment with iodine-125 brachytherapy. SUBJECTS/METHODS In this single-institution retrospective observational case series, all instances of biopsy-confirmed orbital melanoma after known intraocular melanoma were reviewed. Tumour characteristics, clinical course, time to recurrence, cytogenetics of initial tumour and recurrence, and presence of intraocular recurrence were documented. RESULTS Five cases of orbital melanoma following treatment with plaque radiotherapy are described. Tumour staging was Ia (1), IIa (2), and IIb (2). The primary lesion in four of the five appeared to have undergone complete regression for an average of 2 years, with the orbital melanoma developing after this interval. Recurrence of the intraocular tumour was seen in conjunction with an extrascleral component in two cases. Four cases ultimately underwent enucleation or exenteration; three had evidence of direct extension of tumour through the sclera. Four cases in this series had molecular characteristics associated with high metastatic risk (three patients with monosomy 3, one with BAP1 mutation). CONCLUSIONS High-risk tumour biology may predispose to late appearance of extrascleral melanoma despite optimal treatment and adequate control of the intraocular tumour. Extended follow-up with detailed orbital examination and imaging is recommended for this population.
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Affiliation(s)
- Hamzah Mustak
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher Lo
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Liza M Cohen
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Annie Tran
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Robert Almanzor
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tara A McCannel
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Robert A Goldberg
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Daniel B Rootman
- Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA.
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA.
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MacDonald JJ, Jorge-Miller A, Enders CK, McCannel TA, Beran TM, Stanton AL. Visual impairment and depression in uveal melanoma: Optimism and pessimism as moderators. Health Psychol 2021; 40:408-417. [PMID: 34323543 DOI: 10.1037/hea0001080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Uveal melanoma, a rare eye cancer, presents potential vision loss and life threat. This prospective, longitudinal study interrogated the predictive utility of visual impairment, as moderated by optimism/pessimism, on depressive symptoms in 299 adults undergoing diagnostic evaluation. METHOD Depressive symptoms (Center for Epidemiologic Studies Depression Scale), subjective (Measure of Outcome in Ocular Disease vision subscale) and objective (logarithm of the minimum angle of resolution) visual impairment, and optimism/pessimism (Life Orientation Test-Revised) were assessed before diagnostic evaluation and 1 week, 3 months, and 12 months after diagnosis. Multilevel modeling, with repeated measures (Level 1) nested within individuals (Level 2) and imputation of missing data (Blimp software), was performed. RESULTS Depressive symptoms were significantly more elevated 1 week after diagnosis in cancer patients (n = 107) versus patients not diagnosed with cancer (n = 192). Higher subjective (but not objective) visual impairment predicted greater depressive symptoms (p < .001). Across the entire sample, the two-way (Optimism/Pessimism × Subjective Visual Impairment) interactions were statistically significant (ps < .05), but not the three-way interaction (with diagnosis). The positive association between subjective visual impairment and depressive symptoms was significant at low and moderate levels of optimism (ps < .001), but not at high optimism (p > .05). The association was significant at high and moderate levels (ps < .001), but not low (p > .05) levels of pessimism. CONCLUSIONS Elevated depressive symptoms are evident in adults who do (vs. do not) receive a diagnosis of uveal melanoma but appear to remit within 3 months. Perceived impaired vision, especially coupled with low optimism or high pessimism, predicts depressive symptoms over time, with implications for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Craig K Enders
- Department of Psychology, University of California, Los Angeles
| | - Tara A McCannel
- Department of Ophthalmology and Ocular Oncology, Stein and Doheny Eye Institutes, University of California, Los Angeles
| | - Tammy M Beran
- Department of Psychology, University of California, Los Angeles
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Herts KL, Jorge-Miller A, Beran TM, McCannel TA, Wiley JF, Stanton AL. A prospective study of cancer-related benefit finding in uveal melanoma patients. J Behav Med 2020; 44:131-137. [PMID: 32939680 DOI: 10.1007/s10865-020-00175-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
Little is known about contributors to the psychosocial impact of uveal melanoma, a rare cancer. Predictors and outcomes of benefit finding, a potentially favorable outcome, were investigated. Adults (n = 107) completed assessments prior to diagnosis of uveal melanoma and one week, three months and 12 months after diagnosis. Path analyses with the full information maximum likelihood estimation method were conducted. Objective disease impact on vision did not predict benefit finding (p > .05). Approach-oriented coping prior to diagnosis and one week later significantly predicted greater benefit finding 12 months later (p < .01). Avoidance-oriented coping at three months moderated the concurrent relationship of benefit finding and positive affect at 12 months (p < .001). This first study of predictors of benefit finding in uveal melanoma patients suggests that greater approach-oriented coping prospectively predicts higher benefit finding. Further, avoidance may condition the association of benefit finding with psychosocial outcomes.
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Affiliation(s)
- Kate L Herts
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Alexandra Jorge-Miller
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Tammy M Beran
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Tara A McCannel
- Department of Ophthalmology and Stein Eye Institute, UCLA, Los Angeles, CA, USA
| | - Joshua F Wiley
- Monash Institute for Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Annette L Stanton
- Departments of Psychology and Psychiatry/Biobehavioral Sciences, Jonsson Comprehensive Cancer Center, UCLA, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
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Kothari N, Pineles S, Sarraf D, Velez F, Heilweil G, Holland G, McCannel CA, Onclinx T, McCannel TA, Sadda SR, Schwartz SD, Tsui I. Clinic-based ultra-wide field retinal imaging in a pediatric population. Int J Retina Vitreous 2019; 5:21. [PMID: 31890284 PMCID: PMC6907107 DOI: 10.1186/s40942-019-0171-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Pediatric retinal disorders, although uncommon, can be challenging to assess in the clinic setting and often requires an exam under anesthesia. The purpose of our study was to evaluate the use of ultra-wide field retinal imaging in children without sedation in an outpatient clinic. Methods We performed a retrospective case series of patients 18 years or younger who received ultra-wide field imaging over a one year period. The age, gender, and clinical course were documented. Color fundus and red-free images were reviewed to assess field of view. Ultra-wide field autofluorescence (UWF-FAF) was evaluated for abnormal autofluorescence patterns and ultra-wide field fluorescein angiography (UWF-FA) was assessed for angiographic phase and field of view. Results A total of 107 eyes of 55 patients with a mean age of 11.1 years (SD 3.7 years, range 3–18 years) were evaluated. Twenty-seven (49%) patients were male. The most common diagnosis was retinopathy of prematurity (7 of 55 patients, 12.7%) followed by trauma (7.4%), Coats disease (7.4%), and rhegmatogenous retinal detachment (7.4%). The number of quadrants visualized anterior to the equator correlated with patient age (r = 0.4, p < 0.01). On UWF-FA, 6 of 14 patients (43%) had images of the arterial phase captured and 14 of 14 patients (100%) had images of the venous phase or later captured. Conclusions We demonstrated that UWF imaging is obtainable in children as young as 3 years old without sedation. UWF fundus photography, UWF-FAF and UWF-FA were useful clinical adjuvants to examination and provide additional information for documenting and monitoring pediatric retinal diseases.
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Affiliation(s)
- Nikisha Kothari
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Stacy Pineles
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - David Sarraf
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Federico Velez
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Gad Heilweil
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Gary Holland
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Colin A McCannel
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Tania Onclinx
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Tara A McCannel
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - SriniVas R Sadda
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Steven D Schwartz
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
| | - Irena Tsui
- Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA
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Chattopadhyay C, Oba J, Roszik J, Marszalek JR, Chen K, Qi Y, Eterovic K, Robertson AG, Burks JK, McCannel TA, Grimm EA, Woodman SE. Elevated Endogenous SDHA Drives Pathological Metabolism in Highly Metastatic Uveal Melanoma. Invest Ophthalmol Vis Sci 2019; 60:4187-4195. [PMID: 31596927 PMCID: PMC6785781 DOI: 10.1167/iovs.19-28082] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose Metastatic uveal melanoma (UM) has a very poor prognosis and no effective therapy. Despite remarkable advances in treatment of cutaneous melanoma, UM remains recalcitrant to chemotherapy, small-molecule kinase inhibitors, and immune-based therapy. Methods We assessed two sets of oxidative phosphorylation (OxPhos) genes within 9858 tumors across 31 cancer types. An OxPhos inhibitor was used to characterize differential metabolic programming of highly metastatic monosomy 3 (M3) UM. Seahorse analysis and global metabolomics profiling were done to identify metabolic vulnerabilities. Analyses of UM TCGA data set were performed to determine expressions of key OxPhos effectors in M3 and non-M3 UM. We used targeted knockdown of succinate dehydrogenase A (SDHA) to determine the role of SDHA in M3 UM in conferring resistance to OxPhos inhibition. Results We identified UM to have among the highest median OxPhos levels and showed that M3 UM exhibits a distinct metabolic profile. M3 UM shows markedly low succinate levels and has highly increased levels of SDHA, the enzyme that couples the tricarboxylic acid cycle with OxPhos by oxidizing (lowering) succinate. We showed that SDHA-high M3 UM have elevated expression of key OxPhos molecules, exhibit abundant mitochondrial reserve respiratory capacity, and are resistant to OxPhos antagonism, which can be reversed by SDHA knockdown. Conclusions Our study has identified a critical metabolic program within poor prognostic M3 UM. In addition to the heightened mitochondrial functional capacity due to elevated SDHA, M3 UM SDHA-high mediate resistance to therapy that is reversible with targeted treatment.
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Affiliation(s)
| | - Junna Oba
- Melanoma Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Jason Roszik
- Melanoma Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas, United States
- Genomic Medicine, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Joseph R Marszalek
- Institute of Applied Cancer Science & Center for Co-Clinical Trials, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Ken Chen
- Bioinformatics & Computational Biology, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Yuan Qi
- Bioinformatics & Computational Biology, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Karina Eterovic
- Bioinformatics & Computational Biology, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - A Gordon Robertson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Jared K Burks
- Leukemia, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Tara A McCannel
- Stein Eye and Doheny Eye Institutes, University of California Los Angeles, Los Angeles, California, United States
| | - Elizabeth A Grimm
- Melanoma Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas, United States
| | - Scott E Woodman
- Melanoma Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas, United States
- Systems Biology, UT MD Anderson Cancer Center, Houston, Texas, United States
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Williamson TJ, Jorge-Miller A, McCannel TA, Beran TM, Stanton AL. Sociodemographic, Medical, and Psychosocial Factors Associated With Supportive Care Needs in Adults Diagnosed With Uveal Melanoma. JAMA Ophthalmol 2019; 136:356-363. [PMID: 29470565 DOI: 10.1001/jamaophthalmol.2018.0019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance Understanding supportive care needs in patients with cancer is important for developing approaches that enhance quality of life and promote satisfaction with care. Objective To characterize the nature and frequency of sociodemographic, medical, and psychosocial factors associated with unmet needs in patients with uveal melanoma 1 week and 3 months after diagnosis. Design, Setting, and Participants This 3-month, prospective, longitudinal survey study was conducted at a university-based ophthalmology practice from June 1, 2007, to July 1, 2011. Data were analyzed in April 2017. Consecutive patients (n = 429) scheduled for diagnostic evaluation for an intraocular abnormality were assessed for eligibility. Participants were ineligible (n = 25) if they were younger than 18 years, had previous advanced cancer, or evidenced cognitive impairment. Of the patients who provided informed consent (n = 306), those subsequently diagnosed with uveal melanoma by an ophthalmologist (n = 107) were included in the analysis. Main Outcomes and Measures Unmet needs (ie, desire for help in psychological, physical, health information, communication, or social domains) were assessed using the Cancer Needs Questionnaire. Multivariable regression analyses determined factors associated with unmet need severity across 3 months. Results One hundred seven patients (58 [54%] men; mean [SD] age, 59.0 [12.8] years) completed the baseline assessment. At 1 week after diagnosis, nearly all patients (85 of 86 [99%]) expressed at least 1 unmet need, as did 68 of 79 (86%) 3 months later. The most frequently endorsed needs were in the health information and psychological domains. Patients' unmet needs declined significantly over 3 months (mean [SD] change, -10.0 [14.4]; 95% CI, -6.4 to -13.6; t = -5.6). Sociodemographic and medical characteristics were unrelated to unmet need severity. However, higher prediagnosis instrumental social support (b = -0.2; 95% CI, -0.3 to -0.1; z = -2.8) and lower neuroticism (b = 0.3; 95% CI, 0.1-0.5; z = 2.9) predicted lower unmet need severity 1 week after diagnosis. Having a smaller social network predicted lower unmet need severity 3 months after diagnosis (b < 0.1; 95% CI, <0.1 to <0.1; z = 2.4) as well as a decline in needs from diagnosis to 3 months later (b < 0.1; 95% CI, <0.1 to <0.1; z = 2.3). Conclusions and Relevance Within 1 week after diagnosis and 3 months later, most patients with uveal melanoma cited important health information and psychological needs. These findings suggest that prior to or at diagnosis, the severity of such needs and psychosocial factors that may be associated can be identified for proactive supportive intervention.
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Affiliation(s)
| | - Alexandra Jorge-Miller
- Department of Psychology, University of California, Los Angeles.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Tara A McCannel
- Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Tammy M Beran
- Department of Psychology, University of California, Los Angeles
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles.,Cousins Center of Psychoneuroimmunology, Semel Institute, University of California, Los Angeles
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10
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Fatehi N, McCannel TA, Giaconi J, Caprioli J, Law SK, Nouri-Mahdavi K. Outcomes of Glaucoma Drainage Device Surgery in Eyes with Treated Uveal Melanoma. Ocul Oncol Pathol 2019; 5:20-27. [PMID: 30675473 DOI: 10.1159/000488056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/28/2018] [Indexed: 11/19/2022] Open
Abstract
Aim We report patient safety and intraocular pressure (IOP) control after placement of a glaucoma drainage device (GDD) in eyes with a history of treated malignant uveal melanoma. Methods A retrospective review of the records of patients with uveal melanoma was performed. Outcomes were local tumor recurrence, rate of metastases, and to-nometric success, based on survival curves, defined as IOP < 21 mm Hg. Results Eleven eyes with choroidal melanoma, 4 with iris melanoma, and 1 with ciliary body melanoma were followed for a median (interquartile range) of 2.1 (1.1-3.2) years. Two subjects developed liver metastases; one had monosomy 3 and tumor gene expression profile class 2. The other case with ciliary body melanoma was negative for monosomy 3. There were no cases of local treatment failure. Mean preoperative IOP decreased from 30.5 ± 7.7 to 15.9 ± 8.1 mm Hg at 1 year after surgery (1-year success rate 80%). Conclusions Our case series with a median follow-up of 2 years shows that placing a GDD in patients with treated uveal melanoma does not expose patients to greater risk of local or extraocular recurrence. A larger series and longer follow-up time are required to fully evaluate the safety of GDDs in this clinical scenario.
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Affiliation(s)
- Nima Fatehi
- Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Tara A McCannel
- Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - JoAnn Giaconi
- Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Joseph Caprioli
- Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Simon K Law
- Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Stein Eye and Doheny Eye Institutes, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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11
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Yang YM, Chow PE, McCannel TA, Lamb JM. A comparison of the shielding effectiveness of silicone oil vitreous substitutes when used with Palladium-103 and Iodine-125 eye plaques. Med Phys 2018; 46:1006-1011. [PMID: 30554429 DOI: 10.1002/mp.13341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/11/2018] [Accepted: 12/06/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Episcleral eye plaques provide excellent local control of ocular melanoma, but vision sparing remains a significant problem with 30% or more of patients experiencing significant visual acuity degradation. The use of silicone oil shielding with Iodine-125 plaques has previously been reported to improve critical structure sparing. We hypothesized that the use of Palladium-103 would improve the shielding effectiveness of silicone oil due to the strong energy dependence of the photoelectric effect. This Monte Carlo simulation study reports a comparison of the shielding effects of silicone oil when used in conjunction with Pd-103 and with I-125 plaques. MATERIALS AND METHODS GEANT4 was used to simulate eye plaque treatments to an eye with either water-equivalent vitreous humor, or silicone oil in place of the vitreous humor. Two solid gold plaques, 15 and 23 mm, were simulated loaded with I-125 and with Pd-103 source seeds. Seed activity was normalized such that 85 Gy was delivered to the tumor apex in the water-equivalent cases. Tumor apex dose, central axis dose, and inner sclera dose reductions with silicone oil were evaluated. RESULTS Silicone oil resulted in an underdosing to the tumor apex of 6.1% and 7.5% in the 15 mm plaque for I-125 and Pd-103, respectively, and 3.4% and 4.3% in the 23 mm plaque for I-125 and Pd-103, respectively. When renormalized to 85 Gy to the tumor apex in all scenarios, silicone oil reduced the dose to the inner sclera 90° from the plaque by 19-32% for the 15 and 23 mm plaques using I-125, and by 33-65% for the 15 and 23 mm plaques using Pd-103. CONCLUSIONS The combination of silicone oil and Pd-103 eye plaques offers the potential for greatly improved sparing to normal structures compared to Pd-103 plaques alone or I-125 plaques with or without silicone oil.
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Affiliation(s)
- You M Yang
- University of California, Los Angeles, 200 Medical Plaza Ste B265, Los Angeles, CA, 90095, USA
| | - Phillip E Chow
- University of California, Los Angeles, 200 Medical Plaza Ste B265, Los Angeles, CA, 90095, USA
| | - Tara A McCannel
- Department of Ophthalmology, Stein Eye and Doheny Eye Institutes, University of California, 100 Stein PLZ, Los Angeles, CA, 90095, USA
| | - James M Lamb
- University of California, Los Angeles, 200 Medical Plaza Ste B265, Los Angeles, CA, 90095, USA
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12
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Shah SN, Kogachi K, Correa ZM, Schefler AC, Aronow ME, Callejo SA, Cebulla CM, Day-Ghafoori S, Francis JH, Lally S, McCannel TA, Paton KE, Phan IT, Pointdujour-Lim R, Ramasubramanian A, Rath P, Shields CL, Skalet AH, Wells JR, Jennelle RL, Berry JL. Trends in Radiation Practices for Female Ocular Oncologists in North America: A Collaborative Study of the International Society of Ocular Oncology. Ocul Oncol Pathol 2018; 5:54-59. [PMID: 30675478 DOI: 10.1159/000489219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/11/2018] [Indexed: 12/22/2022] Open
Abstract
Background The aim of this study was to determine the known radiation exposure, attitudes, and consequent risk modifications among female ocular oncologists in North America who routinely administer radioactive plaque brachytherapy treatment and are members of the International Society of Ocular Oncology. Methods Nineteen female ocular oncologists completed an anonymous 17-question radiation exposure survey. Results Eleven of the participants chose to routinely wear lead protection during surgery; 8 did not. Fifteen of 19 participants reported using an unloaded "nonactive" template to prepare for plaque implantation. During pregnancy, 11 of 13 participants continued to perform plaque brachytherapy. Eight of these 11 undertook measures to decrease radiation exposure self-reported as lead wear and other. The average reported anxiety regarding fertility was 2.1 (SD, 2.2) on a scale from 1 to 10. Conclusion This study corroborates prior literature that surgeons' exposure to radiation during plaque brachytherapy is minimal. Nonetheless, there remains some anxiety regarding exposure risk to women, due to potential effects on fertility and fetal health. We found variability in exposure monitoring, required training, and precautions during pregnancy amongst this group of surgeons. Improved education and clearer pregnancy guidelines may equip female ocular oncologists with optimal knowledge regarding risk of radiation exposure.
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Affiliation(s)
- Sona N Shah
- USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.,Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Kaitlin Kogachi
- USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.,Children's Hospital Los Angeles, Los Angeles, California, USA
| | | | | | - Mary E Aronow
- Massachusetts Eye and Ear, Retina Service, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Jasmine H Francis
- Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Sara Lally
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tara A McCannel
- University of California, Los Angeles, Los Angeles, California, USA
| | | | - Isabella T Phan
- Kaiser Permanente, Northern California, San Francisco, California, USA
| | | | | | - Pamela Rath
- Everett and Hurite Ophthalmic Association, Pittsburgh, Pennsylvania, USA
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Radiation Oncology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jill R Wells
- Emory Eye Center, Emory University, Atlanta, Georgia, USA
| | - Richard L Jennelle
- Department of Radiation Oncology, University of Southern California, Los Angeles, California, USA
| | - Jesse L Berry
- USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.,Children's Hospital Los Angeles, Los Angeles, California, USA
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Glasgow BJ, McCannel TA. Correlation of Immunocytochemistry of BRCA1-associated Protein-1 (BAP1) With Other Prognostic Markers in Uveal Melanoma. Am J Ophthalmol 2018. [PMID: 29530782 DOI: 10.1016/j.ajo.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Prior studies have shown that nuclear reactivity for BRCA1-associated protein-1 (BAP1) yields prognostic information for paraffin-embedded uveal melanomas. Lacking are immunocytochemical studies of BAP1 on fine needle aspiration biopsies of uveal melanoma that correlate with prognosis or other markers of prognosis. Our purpose was to fill this gap. DESIGN Experimental laboratory study. METHODS Fine needle aspiration biopsies were performed prospectively on 113 patients with uveal melanomas, garnering limited subsets of cases for comparison. Agreement between immunocytochemistry for BAP1 nuclear staining vs chromosome 3 ploidy analysis and gene expression profiling was assessed by 2 × 2 contingency table analysis. RESULTS The presence or absence of suppression of nuclear expression of BAP1 was strongly associated (73%, P = .000002) with monosomy and disomy chromosome 3, respectively. BAP1 nuclear expression was also correlated with gene expression profiling. Chromosome 3 ploidy analysis correlated with gene expression profiles. CONCLUSION When adequate material is obtained, immunocytology using BAP1 is a potentially informative tool for prognostication of uveal melanoma.
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Bozkurt TK, Tang Q, Grunstein LL, McCannel TA, Straatsma BR, Miller KM. Outcomes of cataract surgery in eyes with ocular melanoma treated with iodine-125 brachytherapy. J Cataract Refract Surg 2018; 44:287-294. [PMID: 29703285 DOI: 10.1016/j.jcrs.2017.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/01/2017] [Accepted: 12/06/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate visual and surgical outcomes of cataract surgery in eyes with a history of iodine-125 (I125) brachytherapy for ocular melanoma. SETTING Department of Ophthalmology, David Geffen School of Medicine at UCLA and the Stein Eye Institute, Los Angeles, California, USA. DESIGN Retrospective case series. METHODS Patients with ocular melanoma treated by I125 brachytherapy who subsequently had cataract surgery were evaluated. The recorded data included tumor size, location, preoperative ocular comorbidities, corrected distance visual acuity (CDVA), operative complications, and brachytherapy-related maculopathy before and after surgery. RESULTS Thirty-two eyes of 32 patients were included. The mean age at the time of cataract surgery was 66.1 years. The median follow-up was 53.5 months. There were no intraoperative complications. Eighteen eyes (56.3%) had a history of preoperative radiation retinopathy, 10 involving the macula. Between 2 weeks and 4 weeks postoperatively, 22 eyes (68.8%) had an improvement in CDVA (≥2 lines). Seven of 10 eyes that failed to improve had radiation maculopathy. By the last follow-up examination, 13 eyes (40.6%) had improved CDVA, 9 eyes (28.1%) were worse (≥2 lines), and 10 eyes (31.3%) were unchanged (within ±1 line). Of 15 eyes that lost CDVA gains achieved between 2 weeks and 4 weeks postoperatively, 9 eyes had new-onset or worsening maculopathy. Cataract surgery had no effect on local tumor control or distant metastasis. CONCLUSIONS Cataract surgery after I125 brachytherapy for ocular melanoma improved CDVA in most eyes during the immediate postoperative period. Gains were often lost with further follow-up. Progression of radiation maculopathy was primarily responsible for subsequent visual decline.
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Affiliation(s)
- Tahir Kansu Bozkurt
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Qiongyan Tang
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Lev L Grunstein
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Tara A McCannel
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Bradley R Straatsma
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Kevin M Miller
- From the Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
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Klufas MA, McCannel TA. Response to "Comparison of Gene Expression Profiling and Chromosome 3 Analysis by Fluorescent in situ Hybridization and Multiplex Ligation Probe Amplification in Fine-Needle Aspiration Biopsy Specimens of Uveal Melanoma". Ocul Oncol Pathol 2018; 4:191. [PMID: 29765953 PMCID: PMC5939673 DOI: 10.1159/000481456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 03/26/2024] Open
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Klufas MA, Richter E, Itty S, Moreno C, McCannel CA, McCannel TA. Comparison of Gene Expression Profiling and Chromosome 3 Analysis by Fluorescent in situ Hybridization and Multiplex Ligation Probe Amplification in Fine-Needle Aspiration Biopsy Specimens of Uveal Melanoma. Ocul Oncol Pathol 2017; 4:16-20. [PMID: 29344493 DOI: 10.1159/000468941] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/01/2017] [Indexed: 02/03/2023] Open
Abstract
Purpose The aim of this paper was to assess the concordance between results of DecisionDx-UM specific gene expression profiling (GEP) and fluorescence in situ hybridization (FISH) for chromosome 3 analysis, and between DecisionDx-UM GEP and multiplex ligation probe amplification (MLPA) in uveal melanoma undergoing intraoperative fine-needle aspiration biopsy (FNAB) for metastatic prognostication during brachytherapy. Methods We retrospectively reviewed consecutive patients diagnosed with posterior uveal melanoma who underwent intraoperative FNAB prior to placement of an iodine-125 radioactive plaque between 2012 and 2014. Two cohorts of patients were identified: Cohort 1 - tumors in which both GEP and FISH results were obtained, and Cohort 2 - tumors in which both GEP and MLPA results were obtained. Results Forty-four patients were identified for Cohort 1. FISH and GEP results were discordant in 7 tumors (15.9%). Forty-three patients were identified for Cohort 2. MLPA and GEP were discordant in 7 tumors (16.3%). Conclusions Discordance between GEP and chromosome 3 status by FISH and MLPA occurred in our series at a rate of 15.9 and 16.3%, respectively. Caution must be advised when counseling a patient with a good-prognosis GEP "Class 1" result that the uveal tumor may actually harbor monosomy 3, which is associated with a poor prognosis for metastasis in nearly 20% of the patients.
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Affiliation(s)
- Michael A Klufas
- Department of Ophthalmology at Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Elizabeth Richter
- Department of Ophthalmology at Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Sujit Itty
- Department of Ophthalmology at Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Christian Moreno
- Department of Ophthalmology at Stein Eye Institute, University of California, Los Angeles, CA, USA
| | - Colin A McCannel
- Department of Ophthalmology at Stein Eye Institute, University of California, Los Angeles, CA, USA.,Department of Ophthalmology at Doheny Eye Institute, University of California, Los Angeles, CA, USA
| | - Tara A McCannel
- Department of Ophthalmology at Stein Eye Institute, University of California, Los Angeles, CA, USA.,Department of Ophthalmology at Doheny Eye Institute, University of California, Los Angeles, CA, USA
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Nagiel A, Rootman DB, McCannel TA. PARANEOPLASTIC VITELLIFORM MACULOPATHY IN THE SETTING OF CHOROIDAL MELANOMA: EVOLUTION OVER ONE YEAR. Retin Cases Brief Rep 2017; 11 Suppl 1:S7-S10. [PMID: 27533643 DOI: 10.1097/icb.0000000000000383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND To illustrate the evolution of paraneoplastic vitelliform maculopathy over one year using optical coherence tomography. METHODS Observational case report. RESULTS A 65-year-old man with a history of ocular melanocytosis and choroidal melanoma of the left eye treated with plaque brachytherapy 3 years prior returned for his yearly follow-up visit. The visual acuity in the right eye was 20/20. Subtle thickening of the interdigitation zone layer was noted on optical coherence tomography. Over the following year, multifocal vitelliform detachments developed with progressive enlargement and coalescence of the lesions. Paraneoplastic vitelliform maculopathy developed in the fellow eye of a patient with local recurrence of previously treated choroidal melanoma. CONCLUSION Paraneoplastic vitelliform maculopathy may develop in the fellow eye of a patient with local recurrence of their previously treated choroidal melanoma with no clinical evidence of systemic metastasis.
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Affiliation(s)
- Aaron Nagiel
- *Retina Division, Stein Eye Institute, Los Angeles, California; †Orbital and Ophthalmic Plastic Surgery Division, Stein Eye Institute, Los Angeles, California; and ‡Doheny Eye Institute, Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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18
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Affiliation(s)
- Michael A Klufas
- Stein Eye Institute, Retina Division, University of California, Los Angeles
| | - Colin A McCannel
- Stein Eye Institute, Retina Division, University of California, Los Angeles
| | - Tara A McCannel
- Stein Eye Institute, Retina Division, University of California, Los Angeles
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Affiliation(s)
- Meghna V. Motiani
- Ophthalmic Oncology Center, Stein Eye Institute, Department of Ophthalmology, University of California, David Geffen School of Medicine, Los Angeles (UCLA), California, USA
| | - Robert Almanzor
- Ophthalmic Oncology Center, Stein Eye Institute, Department of Ophthalmology, University of California, David Geffen School of Medicine, Los Angeles (UCLA), California, USA
| | - Tara A. McCannel
- Ophthalmic Oncology Center, Stein Eye Institute, Department of Ophthalmology, University of California, David Geffen School of Medicine, Los Angeles (UCLA), California, USA
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Abstract
PURPOSE To demonstrate the utility of Optos ultra-wide field imaging in the diagnosis and management of choroidal melanoma in the setting of asteroid hyalosis. DESIGN Observational case report. METHOD A 52-year-old female was referred for evaluation of floaters, photopsias, and blurry vision in the right eye. Clinical examination revealed dense asteroid hyalosis obscuring the fundus, and a limited view of a pigmented choroidal lesion in the nasal periphery. Optos ultra-wide field fluorescein angiography and ultrasonography facilitated the diagnosis of a choroidal melanoma. RESULTS The patient underwent Iodine-125 brachytherapy for local tumor control and excellent tumor response was confirmed with serial follow-up Optos imaging and ultrasonography. CONCLUSION Ultra-wide field fundus fluorescein angiography facilitated the diagnosis of a choroidal melanoma, which was obscured by dense asteroid hyalosis, allowing for local tumor control with brachytherapy. Optos wide-field imaging may be a valuable tool for detecting potentially life-threatening lesions in the setting of asteroid hyalosis.
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Affiliation(s)
- Meghna V Motiani
- a Ophthalmic Oncology Center, Jules Stein Eye Institute, Department of Ophthalmology , University of California, Los Angeles (UCLA) , Los Angeles , CA , USA
| | - Colin A McCannel
- a Ophthalmic Oncology Center, Jules Stein Eye Institute, Department of Ophthalmology , University of California, Los Angeles (UCLA) , Los Angeles , CA , USA
| | - Robert Almanzor
- a Ophthalmic Oncology Center, Jules Stein Eye Institute, Department of Ophthalmology , University of California, Los Angeles (UCLA) , Los Angeles , CA , USA
| | - Tara A McCannel
- a Ophthalmic Oncology Center, Jules Stein Eye Institute, Department of Ophthalmology , University of California, Los Angeles (UCLA) , Los Angeles , CA , USA
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21
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Klufas MA, Itty S, McCannel CA, Glasgow BJ, Moreno C, McCannel TA. Variable Results for Uveal Melanoma–Specific Gene Expression Profile Prognostic Test in Choroidal Metastasis. JAMA Ophthalmol 2015; 133:1073-6. [DOI: 10.1001/jamaophthalmol.2015.1790] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Michael A. Klufas
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
| | - Sujit Itty
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
| | - Colin A. McCannel
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
| | - Ben J. Glasgow
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
| | - Christian Moreno
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
| | - Tara A. McCannel
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles
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Tsui I, Beardsley RM, McCannel TA, Oliver SC, Chun MW, Lee SP, Chow PE, Agazaryan N, Yu F, Straatsma BR. Visual Acuity, Contrast Sensitivity and Color Vision Three Years After Iodine-125 Brachytherapy for Choroidal and Ciliary Body Melanoma. Open Ophthalmol J 2015; 9:131-5. [PMID: 26312123 PMCID: PMC4541296 DOI: 10.2174/1874364101509010131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/29/2015] [Accepted: 05/11/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To report visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after iodine-125 brachytherapy for choroidal and ciliary body melanoma (CCM). DESIGN Prospective interventional case series. PARTICIPANTS Thirty-seven patients (37 eyes) with CCM. METHODS Patients had best-corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, Pelli-Robson contrast sensitivity and Hardy-Rand-Rittler color vision measurement; comprehensive ophthalmology examination; optical coherence tomography; and ultrasonography at baseline prior to, 1 year after, 2 years after and 3 years after I-125 brachytherapy. MAIN OUTCOME MEASURES Visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after brachytherapy. RESULTS Nineteen (19) men and 18 women with mean age of 58 years (SD 13, range 30-78) prior to, 1 year after, 2 years after and 3 years after brachytherapy had mean best-corrected visual acuity of 77 letters (20/32), 65 letters (20/50), 56 letters (20/80) and 47 letters (20/125); contrast sensitivity of 30, 26, 22 and 19 letters; color vision of 26, 20, 17 and 14 test figures, respectively. Decrease in visual acuity, contrast sensitivity and color vision was statistically significant from baseline at 1 year, 2 years, and 3 years after brachytherapy. Decreased acuity at 3 years was associated with mid-choroid and macula melanoma location, ≥ 4.1 mm melanoma height, radiation maculopathy and radiation optic neuropathy. CONCLUSION 1, 2 and 3 years after brachytherapy, eyes with CCM had significantly decreased visual acuity, contrast sensitivity and color vision.
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Affiliation(s)
- Irena Tsui
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Robert M Beardsley
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tara A McCannel
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott C Oliver
- Department of Ophthalmology, University of Colorado, Denver, Aurora, CO, USA
| | - Melissa W Chun
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Steve P Lee
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Phillip E Chow
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nzhde Agazaryan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Fei Yu
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bradley R Straatsma
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA
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Abstract
PURPOSE To report a case of choroidal malignant melanoma in a patient with Waardenburg syndrome and bilateral choroidal pigmentary abnormalities. METHODS Clinical examination and multimodal imaging of the case. RESULTS A 45-year-old woman presented with asymptomatic flat choroidal pigmentation abnormalities in both eyes. A choroidal lesion was identified in the inferotemporal periphery of the left eye arising from an area of hyperpigmentation; ultrasonography findings were consistent with a choroidal melanoma. The patient endorsed a personal and family history of premature graying of hair and was identified to have dystopia canthorum consistent with the diagnosis of Waardenburg syndrome. CONCLUSION The authors present the first reported case of concurrent Waardenburg syndrome and choroidal malignant melanoma. This cooccurrence may suggest that the relative hyperpigmented regions in affected fundi may be abnormal and should be monitored closely for the development of choroidal melanoma.
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Affiliation(s)
- Sujit Itty
- Stein Eye Institute, University of California Los Angeles, Los Angeles, California
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McCannel TA, Chmielowski B, Finn RS, Goldman J, Ribas A, Wainberg ZA, McCannel CA. Bilateral Subfoveal Neurosensory Retinal Detachment Associated With MEK Inhibitor Use for Metastatic Cancer. JAMA Ophthalmol 2014; 132:1005-9. [DOI: 10.1001/jamaophthalmol.2014.976] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Tara A. McCannel
- Department of Ophthalmology and Jules Stein Eye Institute, Ophthalmic Oncology Center, University of California, Los Angeles2Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Bartosz Chmielowski
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles3Division of Hematology and Medical Oncology, Department of Medicine, University of California, Los Angeles
| | - Richard S. Finn
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles3Division of Hematology and Medical Oncology, Department of Medicine, University of California, Los Angeles
| | - Jonathan Goldman
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles3Division of Hematology and Medical Oncology, Department of Medicine, University of California, Los Angeles
| | - Antoni Ribas
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles3Division of Hematology and Medical Oncology, Department of Medicine, University of California, Los Angeles
| | - Zev A. Wainberg
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles3Division of Hematology and Medical Oncology, Department of Medicine, University of California, Los Angeles
| | - Colin A. McCannel
- Department of Ophthalmology and Jules Stein Eye Institute, Ophthalmic Oncology Center, University of California, Los Angeles
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Chang MY, McCannel TA. Comparison of uveal melanoma cytopathologic sample retrieval in trans-scleral versus vitrectomy-assisted transvitreal fine needle aspiration biopsy. Br J Ophthalmol 2014; 98:1654-8. [DOI: 10.1136/bjophthalmol-2014-305181] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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McCannel TA, McCannel CA. Iodine 125 Brachytherapy With Vitrectomy and Silicone Oil in the Treatment of Uveal Melanoma: 1-to-1 Matched Case-Control Series. Int J Radiat Oncol Biol Phys 2014; 89:347-52. [DOI: 10.1016/j.ijrobp.2014.02.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 01/29/2014] [Accepted: 02/12/2014] [Indexed: 02/03/2023]
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Chodon T, Comin-Anduix B, Chmielowski B, Koya RC, Wu Z, Auerbach M, Ng C, Avramis E, Seja E, Villanueva A, McCannel TA, Ishiyama A, Czernin J, Radu CG, Wang X, Gjertson DW, Cochran AJ, Cornetta K, Wong DJL, Kaplan-Lefko P, Hamid O, Samlowski W, Cohen PA, Daniels GA, Mukherji B, Yang L, Zack JA, Kohn DB, Heath JR, Glaspy JA, Witte ON, Baltimore D, Economou JS, Ribas A. Adoptive transfer of MART-1 T-cell receptor transgenic lymphocytes and dendritic cell vaccination in patients with metastatic melanoma. Clin Cancer Res 2014; 20:2457-65. [PMID: 24634374 DOI: 10.1158/1078-0432.ccr-13-3017] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE It has been demonstrated that large numbers of tumor-specific T cells for adoptive cell transfer (ACT) can be manufactured by retroviral genetic engineering of autologous peripheral blood lymphocytes and expanding them over several weeks. In mouse models, this therapy is optimized when administered with dendritic cell (DC) vaccination. We developed a short 1-week manufacture protocol to determine the feasibility, safety, and antitumor efficacy of this double cell therapy. EXPERIMENTAL DESIGN A clinical trial (NCT00910650) adoptively transferring MART-1 T-cell receptor (TCR) transgenic lymphocytes together with MART-1 peptide-pulsed DC vaccination in HLA-A2.1 patients with metastatic melanoma. Autologous TCR transgenic cells were manufactured in 6 to 7 days using retroviral vector gene transfer, and reinfused with (n = 10) or without (n = 3) prior cryopreservation. RESULTS A total of 14 patients with metastatic melanoma were enrolled and 9 of 13 treated patients (69%) showed evidence of tumor regression. Peripheral blood reconstitution with MART-1-specific T cells peaked within 2 weeks of ACT, indicating rapid in vivo expansion. Administration of freshly manufactured TCR transgenic T cells resulted in a higher persistence of MART-1-specific T cells in the blood as compared with cryopreserved. Evidence that DC vaccination could cause further in vivo expansion was only observed with ACT using noncryopreserved T cells. CONCLUSION Double cell therapy with ACT of TCR-engineered T cells with a very short ex vivo manipulation and DC vaccines is feasible and results in antitumor activity, but improvements are needed to maintain tumor responses.
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Affiliation(s)
- Thinle Chodon
- Authors' Affiliations: Departments of Medicine, Surgery, Pathology and Laboratory Medicine, Microbiology, Immunology and Molecular Genetics, and Molecular and Medical Pharmacology; Jonsson Comprehensive Cancer Center; Department of Ophthalmology, Jules Stein Eye Institute; Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research; Howard Hughes Medical Institute, University of California, Los Angeles (UCLA); The Angeles Clinic Research Institute, Los Angeles; Department of Medicine, University of California San Diego (UCSD) Moores Cancer Center, La Jolla; Divisions of Chemistry and Biology, California Institute of Technology, Pasadena, California; Department of Medical and Molecular Genetics, Indiana University, and the Indiana University Viral Production Facility (IU VPF), Indianapolis, Indiana; Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada; Mayo Clinic Scottsdale, Scottsdale, Arizona; Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut; and Center for Immunology, Roswell Park Cancer Institute, Buffalo, New York
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Abstract
Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare, intraocular paraneoplastic syndrome characterized by multiple, elevated, pigmented uveal lesions, diffuse thickening of the uveal tract, and rapidly progressive cataracts. We report a 70-year-old Caucasian male with an inferotemporal conjunctival-scleral pigmented lesion of the right eye. Funduscopy and ultrasonography revealed multiple elevated pigmented choroidal lesions in both eyes. Genome-wide single nucleotide polymorphism (SNP) analysis of intraoperative transscleral fine-needle aspiration biopsies from both eyes revealed a whole gain on chromosome 5. BDUMP was diagnosed, and the patient underwent a thorough systemic investigation, which was negative for an underlying malignancy; however, by maintaining a high index of suspicion, multiple malignancies were uncovered and appropriately treated over the ensuing years. This report presents the clinical, cytologic, and cytogenetic features of BDUMP, and is the first to demonstrate a novel finding of a whole gain in chromosome 5 by SNP analysis of the choroidal lesions. Additionally, this is the first case to potentially associate BDUMP and both transitional cell carcinoma of the bladder as well as renal clear cell carcinoma.
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Affiliation(s)
- Ehsan Rahimy
- J ules Stein Eye Institute , UCLA, Los Angeles, California , USA and
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Abstract
AIMS To assess quality of life (QoL) indices and their associations with treatment modality, sociodemographics and cancer-related needs in choroidal melanoma patients. METHODS Patients (N=99) treated at the University of California, Los Angeles, for choroidal melanoma within the prior 5 years (M=2.05) completed questionnaires assessing demographics, cancer-related needs, vision-specific QoL, depressive symptoms and concern about recurrence. Visual acuity, comorbidities, treatment modality (radiotherapy, enucleation) and years since diagnosis were gathered from medical records. Primary analyses were multiple regressions. RESULTS Although concern about cancer recurrence was elevated, QoL was better than in other oncology samples and comparable with healthy samples on some outcomes. Enucleation was associated with worse vision-specific QoL, and presence of comorbid diseases was associated with worse vision-specific QoL, depressive symptoms and concern about cancer recurring (all p values<0.05). Patients who experienced at least one stressful life event in the past year (vs no events) reported more depressive symptoms (p<0.01). Report of more unmet cancer needs was associated with worse vision-specific QoL, depressive symptoms and more concern about recurrence (all p values<0.05), uniquely explaining 4%-12% of the variance. CONCLUSIONS For choroidal melanoma patients, an average of 2 years after treatment, the number of physical comorbidities and unmet cancer needs were the strongest correlates of poorer QoL.
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Affiliation(s)
- Joshua F Wiley
- Department of Psychology, University of California, Los Angeles, , California, USA
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Chang MY, Rao NP, Burgess BL, Johnson L, McCannel TA. Heterogeneity of monosomy 3 in fine needle aspiration biopsy of choroidal melanoma. Mol Vis 2013; 19:1892-900. [PMID: 24049435 PMCID: PMC3774574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 09/04/2013] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To report on the heterogeneity of monosomy 3 in a fine needle aspiration biopsy obtained transsclerally from choroidal melanoma for prognosis. METHODS All clinical records for patients who had been diagnosed with choroidal melanoma and underwent iodine-125 plaque brachytherapy with intraoperative transscleral fine needle aspiration biopsy from January 2005 to August 20, 2011, and who had a positive result for monosomy 3 according to fluorescence in situ hybridization as reported by clinical cytogenetics testing were collected. Patient age and sex, total number of cells evaluated and number of cells positive for monosomy 3, tumor size, and metastatic outcome were recorded for each patient. RESULTS A positive result for monosomy 3 was reported in 93 patients who underwent transscleral fine needle aspiration biopsy. Two patients were lost to follow-up immediately post-operatively, and the remaining 91 patients were included in this study. The mean number of cells evaluated in the biopsy was 273 (range 28 to 520). The mean percentage of cells positive for monosomy 3 was 62.9% (range 4.7%-100%). The mean tumor height was 5.91 mm (range 1.99 to 10.85 mm). Larger tumors were associated with a higher percentage of cells positive for monosomy 3. During the average follow-up interval of 28.9 months (range 3-76 months), choroidal melanoma metastasis developed in 18 (20%) patients. Patients whose tumors had 1%-33% of cells positive for monosomy 3 had a significantly lower risk of metastasis-related death compared to patients whose tumors harbored a higher percentage of monosomy 3 (p = 0.04). CONCLUSIONS Cytogenetic heterogeneity of fluorescent in situ hybridization for monosomy 3 exists in a biopsy sample. Larger tumors were more likely to have a higher percentage of monosomy 3 positive cells in the sample. Furthermore, patients whose tumors had more than 33% of cells positive for monosomy 3 had a poorer prognosis than patients whose tumors had lower percentages of monosomy 3.
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Affiliation(s)
- Melinda Y. Chang
- Department of Ophthalmology, University of California, Los Angeles, CA,Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - Nagesh P. Rao
- Department of Ophthalmology, University of California, Los Angeles, CA,Department of Laboratory and Pathology Medicine, University of California, Los Angeles, CA
| | - Barry L. Burgess
- Department of Ophthalmology, University of California, Los Angeles, CA,Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - Lariza Johnson
- Department of Ophthalmology, University of California, Los Angeles, CA,Jules Stein Eye Institute, University of California, Los Angeles, CA
| | - Tara A. McCannel
- Department of Ophthalmology, University of California, Los Angeles, CA,Jules Stein Eye Institute, University of California, Los Angeles, CA
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Abstract
BACKGROUND Retinal pigment epithelium (RPE) adenoma is an extremely rare tumor of the posterior segment which must be differentiated from other choroidal tumors, such as choroidal nevus or melanoma. We report the case of a patient with RPE adenoma coincident with macular pucker who underwent successful pars plana vitrectomy and membrane peeling. PATIENT AND METHODS A 58-year-old female patient was diagnosed with RPE adenoma and epiretinal membrane and subsequently underwent pars plana vitrectomy and epiretinal membrane peeling. RESULTS RPE adenoma was diagnosed and, following vitrectomy with membrane peeling vision, improved to 20/20 with resolution of symptoms of distortion. Sixteen months of follow-up revealed no clinical change in the RPE adenoma and stable vision. CONCLUSION The diagnosis of RPE adenoma can be made upon consideration of unique clinical characteristics of these benign tumors. RPE adenoma may be more closely associated with epiretinal membrane than previously believed, given recent advances in imaging technology. We describe our management strategy, which included observation of the adenoma and surgical removal of the epiretinal membrane.
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Affiliation(s)
- D G Cupp
- Department of Ophthalmology, UCLA-Jules Stein Eye Institute , Los Angeles, California , USA
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Abstract
Local treatment failure after globe-conserving therapy for choroidal melanoma is a surgical complication with significant morbidity to the vision and eye. Few reports in the literature have addressed this complication exclusively. A review of the published literature with reference to local treatment failure in the management of choroidal melanoma was performed to make known the potential differences in failure rates between treatment modalities and methods. A search of the literature regarding local treatment failure was performed to identify relevant studies using combinations of the following keywords on PubMed: uveal melanoma, choroidal melanoma, local recurrence, local failure, endoresection, gamma knife, radiotherapy, helium, iodine, proton, palladium, ruthenium, trans-scleral resection, transpupillary thermotherapy. Further studies were found by searching the text and references of previously identified studies for articles reporting local treatment failure rates in choroidal melanoma. Among the 49 studies identified, the local treatment failure rate ranged from 0% to 55.6%, with follow-up ranging from 10 to 150 months. The two most widely used forms of radiation therapy, iodine-125 and ruthenium-106 brachytherapy, were both associated with a local recurrence rate of 9.6%. The weighted-average of treatment failure in all radiation therapies was 6.15% compared with 18.6% in surgical and 20.8% in laser therapies. Rates of local treatment failure for globe-conserving therapy of choroidal melanoma varied widely between modalities and between centres using similar modalities. Radiation therapy overall resulted in lower local treatment failures compared with surgical or transpupillary thermotherapy.
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Affiliation(s)
- Melinda Y Chang
- Department of Ophthalmology and Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, California 90095, USA
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Beardsley RM, McCannel CA, McCannel TA. Recurrent Leakage After Visudyne Photodynamic Therapy for the Treatment of Circumscribed Choroidal Hemangioma. Ophthalmic Surg Lasers Imaging Retina 2013; 44:248-51. [DOI: 10.3928/23258160-20130503-07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/26/2013] [Indexed: 11/20/2022]
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Wen JC, Sai V, Straatsma BR, McCannel TA. Radiation-related cancer risk associated with surveillance imaging for metastasis from choroidal melanoma. JAMA Ophthalmol 2013; 131:56-61. [PMID: 23307209 DOI: 10.1001/jamaophthalmol.2013.564] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To estimate the lifetime attributable risk of cancer associated with whole-body positron emission tomography (PET)/computed tomography (CT) and with CT of the chest, abdomen, and pelvis if performed at various frequencies and for different durations for surveillance of patients with primary choroidal or ciliary body melanoma for distant metastasis. METHODS Effective radiation doses for whole-body CT and for CT of the chest, abdomen, and pelvis were calculated using Monte Carlo simulation studies. The effective dose of the PET scan was estimated by multiplying fludeoxyglucose F18 radioactivity with dose coefficients. Lifetime attributable risks of cancer were calculated using the approach described in the Biological Effects of Ionizing Radiation VII report. RESULTS For a 50-year-old patient, an annual CT of the chest, abdomen, and pelvis for 10 years carries an estimated lifetime attributable risk of cancer of 0.9% for male patients and 1.3% for female patients, whereas an annual PET/CT each year for 10 years carries an estimated lifetime attributable risk of cancer of 1.6% for male patients and 1.9% for female patients. Lifetime risk was found to be higher in younger, female patients. The lifetime attributable risk of cancer was estimated to be as high as 7.9% for a 20-year-old female patient receiving a PET/CT scan every 6 months for 10 years. CONCLUSIONS Aggressive surveillance protocols incorporating CT scanning or PET/CT scanning for detection of metastasis from primary choroidal or ciliary body melanoma appear to confer a significant substantial risk of a secondary malignant tumor in patients who do not succumb to metastatic melanoma within the first few posttreatment years.
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Affiliation(s)
- Joanne C Wen
- Jules Stein Eye Institute, University of California, Los Angeles, CA 90095-7000, USA
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Abràmoff M, Abrams GW, Agarwal A, Ai E, Aiello LM, Aiello LP, Albert DM, Aschbrenner MW, Ávila M, Aylward GW, Bedell M, Belfort R, Bennett J, Bergstrom C, Besirli CG, Bhende PS, Binder S, Bird AC, Blodi BA, Blumenkranz MS, Boldt HC, Bornfeld N, Bottoni F, Boulton ME, Bowne SJ, Brantley MA, Bressler NM, Bressler SB, Bringmann A, Brinton DA, Brown GC, Brown JC, Brunner S, Bush RA, Cao D, Capone A, Carruthers D, Cavallerano JD, Chakravarthy U, Chan CC, Chan W, Charles S, Charteris DG, Chen DF, Chen J, Chen Y, Cheung CYL, Chew EY, Chiang A, Chiang MF, Constable IJ, Coscas G, Cruess AF, Cunningham ET, Curcio CA, Daiger SP, Damato BE, Davis JL, Davis MD, Day S, De Potter P, de Smet MD, Denniston AK, Dhaliwal RS, Ding X, Do DV, Dou G, Dunn WA, Ehlers JP, Engelbert M, Faia LJ, Falsini B, Fawzi AA, Fekrat S, Feldon SE, Fernandes RAB, Ferreyra HA, Ferrington DA, Ferris FL, Finger PT, Fisher SK, Fishman GA, Fleckenstein M, Flynn HW, Fok AC, Foulds WS, Freeman WR, Freton A, Friedlander M, Frishman LJ, Fu AD, Garcia Filho CADA, Garcia-Valenzuela E, Gaudric A, Gayed M, Genead MA, Gerding H, Giani A, Goldberg MF, Gombos DS, Gopal L, Gordon C, Goto H, Gragoudas ES, Grant MB, Green WR, Gregg RG, Gregor Z, Gregori G, Gregory-Evans K, Grob S, Groenewald C, Grossniklaus HE, Grover S, Gullapalli VK, Gupta A, Guthoff RF, Hahn P, Haller JA, Harbour JW, Haritoglou C, Hartnett ME, Hawkins BS, He S, Herwig MC, Heussen FM, Hinton DR, Holz FG, Houston SK, Hui YN, Humayun MS, Ikuno Y, Isaac D, Ishibashi T, Jabs DA, Jaffe GJ, Jampol LM, Joffe L, Johnson M, Johnson MW, Johnson RN, Joussen AM, Julian K, Jumper JM, Kaiser PK, Kampik A, Katamay R, Kay CN, Keane PA, Kenney MC, Khaderi KR, Khodair MA, Kim IK, Kim TW, Kirchhof B, Klein BE, Klein R, Konstantinidis L, Kozak I, Kuppermann BD, Labriola LT, Lai TY, Lam DS, Lam LA, Landers MB, Lane AM, Lavik EB, Leary JF, Lee SY, Lee TC, Leung LSB, Lewis DA, Lewis GP, Leys A, Li X, Liakopoulos S, Lin CP, Lin P, Liu DT, London NJ, Lujan BJ, Luo Y, Lutty GA, MacLaren R, Madreperla S, Maguire AM, Mainster MA, Mansfield NC, Markoe AM, Marmor MF, Martin DF, Massey SC, McCall MA, McCannel TA, McCutchan JA, McDonald HR, Mehta MP, Meier P, Merbs S, Meredith TA, Meyer CH, Mieler WF, Miller JW, Mirza RG, Mitter SK, Mittra RA, Miyake Y, Montemagno C, Moshiri A, Mruthyunjaya P, Muccioli C, Mullins RF, Murata T, Murphree AL, Murphy RP, Murray PI, Murray TG, Nagpal M, Namperumalsamy P, Nanda SK, Nguyen QD, Nussenblatt RB, Oh KT, Ohji M, Ohno-Matsui K, Palanker D, Patel PS, Pavlick AC, Peereboom DM, Pennesi ME, Pepose JS, Perry JD, Puliafito CA, Quiram PA, Raman R, Ramchandran RS, Rao HV, Rao NA, Rao PK, Rathinam SR, Recchia FM, Redmond KJ, Reh TA, Reichenbach A, Ritch R, Rosenfeld PJ, Rubin GS, Ruiz-Garcia H, Ryan SJ, Sadda SR, Sadun AA, Sakamoto T, Sampath AP, Schachat AP, Schmitz-Valckenberg S, Schwartz SG, Scott AW, Sebag J, Seddon JM, Sen HN, Sepah YJ, Sharma S, Sharma T, Sheu SJ, Shields CL, Shields JA, Shinoda K, Shukla D, Sieving PA, Silva PA, Silveira C, Singh AD, Smith SB, Smith WM, Sobrin L, Sodhi A, Sohn EH, Soubrane G, Spielberg L, Srivastava SK, Stachs O, Staurenghi G, Sternberg P, Stone EM, Sugino IK, Sullivan LS, Sullivan P, Sun JK, Sunness JS, Tadayoni R, Tang S, Terasaki H, Thomas MA, Thompson JT, Thumann G, Toth CA, Trese MT, Tsai JH, Turell ME, Turner PL, Udar N, Ulrich JN, Van Gelder RN, van Meurs JC, Vasconcelos-Santos DV, Vavvas DG, Vemulakonda GA, Wang H, Wang Y, Weiland JD, Weleber RG, Wharam MD, Wickham L, Wiedemann P, Wiley HE, Wilkinson C, Wilson DJ, Wolfensberger TJ, Wong D, Wong IY, Wong TY, Wu DM, Yandiev Y, Yang CH, Yang CM, Yannuzzi LA, Yasuda M, Yeh PT, Yehoshua Z, Yiu G, Yoon YH, Yu HG, Yuan A, Zarbin MA, Zhang JJ, Zhang K, Zhao M, Zhou P. Contributors. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00159-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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von Euw E, Atefi M, Attar N, Chu C, Zachariah S, Burgess BL, Mok S, Ng C, Wong DJ, Chmielowski B, Lichter DI, Koya RC, McCannel TA, Izmailova E, Ribas A. Antitumor effects of the investigational selective MEK inhibitor TAK733 against cutaneous and uveal melanoma cell lines. Mol Cancer 2012; 11:22. [PMID: 22515704 PMCID: PMC3444881 DOI: 10.1186/1476-4598-11-22] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 04/19/2012] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND TAK733 is a novel allosteric, non-ATP-binding, inhibitor of the BRAF substrates MEK-1/2. METHODS The growth inhibitory effects of TAK733 were assessed in a panel of 27 cutaneous and five uveal melanoma cell lines genotyped for driver oncogenic mutations. Flow cytometry, Western blots and metabolic tracer uptake assays were used to characterize the changes induced by exposure to TAK733. RESULTS Fourteen cutaneous melanoma cell lines with different driver mutations were sensitive to the antiproliferative effects of TAK733, with a higher proportion of BRAFV600E mutant cell lines being highly sensitive with IC50s below 1 nM. The five uveal melanoma cell lines had GNAQ or GNA11 mutations and were either moderately or highly sensitive to TAK733. The tested cell lines wild type for NRAS, BRAF, GNAQ and GNA11 driver mutations were moderately to highly resistant to TAK733. TAK733 led to a decrease in pERK and G1 arrest in most of these melanoma cell lines regardless of their origin, driver oncogenic mutations and in vitro sensitivity to TAK733. MEK inhibition resulted in increase in pMEK more prominently in NRASQ61L mutant and GNAQ mutant cell lines than in BRAFV600E mutant cell lines. Uptake of the metabolic tracers FDG and FLT was inhibited by TAK733 in a manner that closely paralleled the in vitro sensitivity assays. CONCLUSIONS The MEK inhibitor TAK733 has antitumor properties in melanoma cell lines with different oncogenic mutations and these effects could be detectable by differential metabolic tracer uptake.
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Affiliation(s)
- Erika von Euw
- Department of Medicine, Division of Hematology/Oncology, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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McCannel TA, Chang MY, Burgess BL. Multi-Year Follow-up of Fine-Needle Aspiration Biopsy in Choroidal Melanoma. Ophthalmology 2012; 119:606-10. [DOI: 10.1016/j.ophtha.2011.08.046] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 08/30/2011] [Accepted: 08/30/2011] [Indexed: 02/03/2023] Open
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McCannel TA, Burgess BL, Nelson SF, Eskin A, Straatsma BR. Genomic identification of significant targets in ciliochoroidal melanoma. Invest Ophthalmol Vis Sci 2011; 52:3018-22. [PMID: 20688739 DOI: 10.1167/iovs.10-5864] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To identify genomic targets for ciliochoroidal melanoma diagnosis, prognosis, and therapy. METHODS Fifty-eight ciliochoroidal melanomas were analyzed by high-resolution, genome-wide, single nucleotide polymorphism (SNP) mapping arrays. The 58 SNP arrays were compared to 48 HapMap normals representing both sexes and assessed with a systematic statistical method, Genomic Identification of Significant Targets in Cancer (GISTIC), to identify significant ciliochoroidal chromosomal abnormalities including chromosome-arm-sized as well as focal events of amplification and deletion. The 58 SNP arrays were also analyzed to assess copy number. RESULTS The 58 ciliochoroidal melanomas analyzed by GISTIC showed large regions of chromosome amplification on 6p and 8q in addition to focal amplification peaks on 1q31.3, 4p16.2, 9p23, and 9q33.1. The melanomas also showed large regions of deletion on 1p and all of 3, 6q, 8p, and 16q, as well as focal deletion peaks on 2p12, 2q14.3, 4q26, 5q21.1, 7q21.11, 8p21.3, 9p21.1, 13q21.31, 13q31.3, and 16q23.3. For each large region and focal peak, the statistical significance was computed, and known genes were specified. CONCLUSIONS High-resolution analysis of ciliochoroidal melanoma cytogenetic aberration patterns supports the utility of systematic characterization of the cancer genome by corroborating known melanoma-related genomic aberrations and identifying additional melanoma-related genomic abnormalities that can be used to identify potential targets for diagnosis, prognosis and therapy.
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Affiliation(s)
- Tara A McCannel
- Department of Ophthalmology, University of California, Los Angeles, California, USA.
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Burgess BL, Rao NP, Eskin A, Nelson SF, McCannel TA. Characterization of three cell lines derived from fine needle biopsy of choroidal melanoma with metastatic outcome. Mol Vis 2011; 17:607-15. [PMID: 21386926 PMCID: PMC3049736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 02/15/2011] [Indexed: 10/29/2022] Open
Abstract
PURPOSE To report three low-passage cell lines from primary choroidal melanoma with metastatic outcome, which were stable for cytogenetic patterns and expression profiles of the primary melanoma. METHODS In patients with choroidal melanoma, transscleral fine needle aspiration biopsy (FNAB) was performed immediately before plaque placement for (125)iodine brachytherapy or immediately after enucleation. Cells were examined for cytopathology, evaluated by fluorescence in-situ hybridization (FISH) for the centromere of chromosome 3, analyzed by 250K whole genome Mapping Array and U133 plus 2.0 Expression Array, and placed in cell culture. At passage 3, the cell lines were analyzed by Mapping Array and Expression Array. RESULTS Three cell lines were propagated from primary choroidal melanomas in three patients who subsequently developed metastasis. Two cell lines were stable for the entire chromosomal aberration pattern of the respective primary tumor. In the third, necrotic material from the biopsy prevented further analysis, yet resulted in a stable cell line. Each cell line had chromosome 3 loss, 6q loss, 8p loss, multiple 8q gain, and 16q loss. Additionally, two cell lines had chromosome 6p gain. Two cell lines had RNA expression profiles similar to the respective primary tumors; the third cell line had a similar RNA expression profile relative to the other two cell lines. CONCLUSIONS FNAB of primary choroidal melanomas resulted in highly characterized, low-passage cell lines, which were stable for the cytogenetic patterns and expression profiles found in the primary tumor. These cell lines represent novel tools for the study of metastatic choroidal melanoma biology.
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Affiliation(s)
- Barry L. Burgess
- Department of Ophthalmology, University of California, Los Angeles, The Jules Stein Eye Institute, Los Angeles, CA
| | - Nagesh P. Rao
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Ascia Eskin
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA
| | - Stanley F. Nelson
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA
| | - Tara A. McCannel
- Department of Ophthalmology, University of California, Los Angeles, The Jules Stein Eye Institute, Los Angeles, CA
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McCannel TA, Wu MY, Burgess BL. Clinical and cytogenetic characteristics of choroidal melanoma in Vietnamese Asians. Mol Vis 2011; 17:231-6. [PMID: 21270969 PMCID: PMC3025820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 01/17/2011] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To report the clinical and cytogenetic characteristics of choroidal melanoma in Vietnamese Asians. METHODS In three Vietnamese Asians with choroidal melanoma, transscleral fine needle aspiration biopsy (FNAB) was performed immediately before iodine-125 brachytherapy. Biopsy was examined for cytopathology, fluorescence in situ hybridization (FISH) for the centromere of chromosome 3, and analyzed by 250K whole genome Mapping Array and U133 plus 2.0 Expression Array. RESULTS Three Vietnamese Asian men (50, 59, and 30 years of age) with clinical diagnosis of choroidal melanoma and no evidence of metastasis had FNAB immediately before Iodine-125 brachytherapy. Cytopathology showed heavily pigmented cells suggestive of or consistent with melanoma. Mapping Array and Expression Array revealed cytogenetic aberrations and gene expression profiles characteristic of choroidal melanoma. One patient (Case 2) with chromosome 3 loss and chromosome 8q gain developed biopsy-proven liver metastasis three years after brachytherapy. One patient (Case 1) with chromosome 6p, 9q and 17q gain and a second patient (Case 3) with 6p, 8q and 9q gains and losses in 6q and 8p have had no evidence of metastasis three years after brachytherapy. CONCLUSIONS In this series of Vietnamese Asians with heavily pigmented choroidal melanoma, the clinical characteristics, cytogenetic aberrations and gene expression profiles were similar to characteristics in other ethnic/racial groups and the cytogenetic aberration of chromosome 3 loss was associated with the development of liver metastasis.
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Affiliation(s)
- Tara A. McCannel
- Department of Ophthalmology and the Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA
| | - Melinda Y. Wu
- Washington University School of Medicine, St. Louis, MO
| | - Barry L. Burgess
- Department of Ophthalmology and the Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA
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Marathe OS, Wu J, Lee SP, Yu F, Burgess BL, Leu M, Straatsma BR, McCannel TA. Ocular response of choroidal melanoma with monosomy 3 versus disomy 3 after iodine-125 brachytherapy. Int J Radiat Oncol Biol Phys 2010; 81:1046-8. [PMID: 20932685 DOI: 10.1016/j.ijrobp.2010.07.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 07/04/2010] [Accepted: 07/05/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after (125)I brachytherapy. METHODS AND MATERIALS We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for (125)I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. RESULTS Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). CONCLUSION In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.
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Affiliation(s)
- Omkar S Marathe
- David Geffen School of Medicine, University of Los Angeles, Los Angeles, CA, USA
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McCannel TA, Burgess BL, Rao NP, Nelson SF, Straatsma BR. Identification of candidate tumor oncogenes by integrative molecular analysis of choroidal melanoma fine-needle aspiration biopsy specimens. ACTA ACUST UNITED AC 2010; 128:1170-7. [PMID: 20837802 DOI: 10.1001/archophthalmol.2010.180] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To report integrative molecular analysis of choroidal melanoma fine-needle aspiration biopsy specimens to identify candidate tumor oncogenes. METHODS Thirty-one choroidal melanoma fine-needle aspiration biopsy specimens were analyzed using cytopathologic diagnosis of melanoma, fluorescence in situ hybridization for chromosome 3, cytogenetic characterization (GeneChip Human 250K NSPI Mapping Arrays; Affymetrix, Santa Clara, California), and gene expression profiles (GeneChip Human Genome U133 Plus 2.0 Arrays, Affymetrix). These analyses were performed by clustering of cytogenetic aberrations, sorting by chromosome 3 loss and chromosome 6p gain, and comparing gene expression profiles in chromosome 3 loss- and chromosome 6p-gain tumors to identify genes with differential expression based on cytogenetic characteristics. RESULTS Of 31 choroidal melanoma biopsy specimens included in this study, 19 tumors had chromosome 3 loss, and 12 tumors without chromosome 3 loss had chromosome 6p gain. Comparative RNA analysis for these 2 groups revealed 49 genes with greater than 4-fold higher expression and 31 genes with greater than 4-fold lower expression in chromosome 3-loss tumors relative to chromosome 6p-gain tumors. CONCLUSIONS Molecular analysis of choroidal melanoma fine-needle aspiration biopsy specimens demonstrated 2 cytogenetically distinct groups characterized by chromosome 3 loss or chromosome 6p gain. In chromosome 3-loss melanomas relative to chromosome 6p-gain melanomas, integrative RNA analysis revealed genes with higher expression and lower expression and identified several genes that have not been reported in previous studies. CLINICAL RELEVANCE Genes differentially expressed between chromosome 3-loss and chromosome 6p-gain melanomas may provide new knowledge about the biologic nature of choroidal melanoma and may contribute to the development of targeted therapies.
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Affiliation(s)
- Tara A McCannel
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Jules Stein Eye Institute, Los Angeles, CA 90095-7000, USA.
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Reddy S, Gorin MB, McCannel TA, Tsui I, Straatsma BR. Novel KRIT1/CCM1 mutation in a patient with retinal cavernous hemangioma and cerebral cavernous malformation. Graefes Arch Clin Exp Ophthalmol 2010; 248:1359-61. [PMID: 20306072 PMCID: PMC2910301 DOI: 10.1007/s00417-010-1329-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 01/19/2010] [Accepted: 02/04/2010] [Indexed: 11/11/2022] Open
Abstract
Backround Retinal cavernous hemangiomas are rare vascular anomalies, and can be associated with cerebral cavernous malformations (CCM). Distinct mutations have been reported in patients who have both CCMs and retinal cavernous hemangiomas. Methods Fluorescein angiography, spectral domain optical coherence tomography, and genetic testing were performed on a patient with a retinal cavernous hemangioma and a CCM. Results Our patient was heterozygous in the KRIT1/CCM1 gene for a frameshift mutation, c.1088delC. This would be predicted to result in premature protein termination. Discussion We have identified a novel mutation in the KRIT1/CCM1 gene in a patient with both CCM and retinal cavernous hemangioma. We hypothesize that the occurrence of retinal cavernous hemangiomas and CCMs is underlaid by a common mechanism present in the KRIT1/CCM1 gene.
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Affiliation(s)
- Shantan Reddy
- NYU Langone Medical Center, 530 First Avenue, New York, NY 10016, USA.
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Ribas A, Comin-Anduix B, Chmielowski B, Jalil J, de la Rocha P, McCannel TA, Ochoa MT, Seja E, Villanueva A, Oseguera DK, Straatsma BR, Cochran AJ, Glaspy JA, Hui L, Marincola FM, Wang E, Economou JS, Gomez-Navarro J. Dendritic cell vaccination combined with CTLA4 blockade in patients with metastatic melanoma. Clin Cancer Res 2009; 15:6267-76. [PMID: 19789309 DOI: 10.1158/1078-0432.ccr-09-1254] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Tumor antigen-loaded dendritic cells (DC) are believed to activate antitumor immunity by stimulating T cells, and CTL-associated antigen 4 (CTLA4)-blocking antibodies should release a key negative regulatory pathway on T cells. The combination was tested in a phase I clinical trial in patients with advanced melanoma. EXPERIMENTAL DESIGN Autologous DC were pulsed with MART-1(26-35) peptide and administered with a dose escalation of the CTLA4-blocking antibody tremelimumab. Sixteen patients were accrued to five dose levels. Primary end points were safety and immune effects; clinical efficacy was a secondary end point. RESULTS Dose-limiting toxicities of grade 3 diarrhea and grade 2 hypophysitis developed in two of three patients receiving tremelimumab at 10 mg/kg monthly. Four patients had an objective tumor response, two partial responses and two complete responses, all melanoma free between 2 and 4 years after study initiation. There was no difference in immune monitoring results between patients with an objective tumor response and those without a response. Exploratory gene expression analysis suggested that immune-related gene signatures, in particular for B-cell function, may be important in predicting response. CONCLUSION The combination of MART-1 peptide-pulsed DC and tremelimumab results in objective and durable tumor responses at the higher range of the expected response rate with either agent alone.
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Affiliation(s)
- Antoni Ribas
- Department of Medicine, Division of Hematology/Oncology, University of California at Los Angeles, Los Angeles, California 90095-1782, USA.
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Jain A, Shah SP, Tsui I, McCannel TA. The Value of Optos Panoramic 200MA™ Imaging for the Monitoring of Large Suspicious Choroidal Lesions. Semin Ophthalmol 2009; 24:43-4. [DOI: 10.1080/08820530802520384] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Shah SP, Jain A, Tsui I, McCannel TA. Optos Optomap Panoramic 200MA™ Imaging of a Serous Choroidal Detachment Responsive to Furosemide. Semin Ophthalmol 2009; 24:40-2. [DOI: 10.1080/08820530802520236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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