Short CommunicationsNeoadjuvant intravitreal ranibizumab treatment in high-risk ocular melanoma patients a two-stage single-centre phase II single-arm studyHussain, Rumana N.; Heimann, Heinrich; Damato, BertilAuthor Information Liverpool Ocular Oncology Centre, St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK Received 13 April 2019 Accepted 19 June 2019 Correspondence to Rumana N. Hussain, MBBS, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK, Tel: +44 151 706 3000; fax: +44 151 706 3973; e-mail: firstname.lastname@example.org Melanoma Research: February 2020 - Volume 30 - Issue 1 - p 102-106 doi: 10.1097/CMR.0000000000000635 Buy Metrics Abstract Despite an established history of intraocular antivascular endothelial growth factor (anti-VEGF) agents therapy in a variety of ocular pathologies as well as other cancer forms, use in the primary treatment of uveal melanoma has not been well assessed. This was a two-stage therapeutic and exploratory phase II, non-randomised, single centre trial involving intraocular treatment with 0.5 mg in 0.05 ml of ranibizumab via six intravitreous injections over 6 months in patients with primary ocular melanoma that otherwise required radical surgery because of tumour size. Seven patients were recruited with a median age of 66 years. At baseline, the longest basal diameter was 15.1 mm (mean, range 10–20.4 mm) with a height measured by ultrasonography of 9.2 mm (mean, range 6.6–12.7 mm). No patients achieved complete or partial response at any visit. All required enucleation. Histopathological analysis revealed mixed cell melanoma in 5/7 (71%) and spindle cell morphology in 2/7 (29%) with ciliary body involvement in 4/7 (57%) and the presence of closed loops also in 4/7 (57%). Genetic analysis demonstrated loss of chromosome 3 in 5/7 (71%) but abnormalities in chromosome 1,6 or 8 in all cases. Our study was terminated early as alternative treatments were clearly superior for local tumour control. There continues to be a role of intravitreal anti-VEGF for the treatment of the sequelae of local radiotherapy in the form of radiation retinopathy and so these agents may be used as adjuncts in the treatment of uveal melanoma rather than as a primary treatment. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.