Current treatments and trials in uveal melanoma

Treatment options for uveal melanomas include radiation using brachytherapy or charged particle beams, photocoagulation, laser, eye wall resection, and enucleation. Goals of therapy are to avoid metastatic disease and, if possible, retain both the eye and good vision. Obviously, treatment options are controversial. Questions remain regarding enucleation vs other forms of therapy, and the author presents guidelines to consider in structuring clinical trials to answer them. They include: Will entry in a trial provide optimum clinical care for the patient? Does the trial ask a valid, important question? Does the trial produce significant answers in a short enough time so that the information is relevant?