Targeted therapy for eye cancer

Targeted therapy is sometimes used to treat advanced eye cancer. Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

You may have targeted therapy to:

• kill eye cancer cells
• deliver a radioactive substance to a tumour
• relieve pain or control the symptoms of advanced eye cancer (called palliative therapy)
• manage side effects related to radiation therapy

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments, such as chemotherapy.

There are different types of targeted therapy used to treat advanced eye cancer.

Monoclonal antibodies have been designed in a lab to recognize and lock onto particular protein markers on the surface of some cancer cells. Monoclonal antibodies used to treat advanced eye cancer include:

Rituximab (Rituxan) is given by an injection into a vein (intravenous) or directly into the eye (intraocular). It is sometimes used to treat lymphoma of the eye. Rituximab targets the CD20 proteins that are found on the surface of many lymphoma cells.

Ibritumomab (Zevalin) is a type of radioimmunotherapy used to treat lymphoma of the eye. It is given as an injection into a vein. Ibritumomab is similar to rituximab and also targets the CD20 protein. But it has a radioactive molecule attached to the drug that also delivers radiation to the cancer cells.

Bevacizumab (Avastin) is sometimes used to treat vision loss caused by damage to blood vessels from radiation therapy. Bevacizumab is a monoclonal antibody that helps to shrink blood vessels. It targets the vascular endothelial growth factor (VEGF), a protein involved in the growth of blood vessels. Bevacizumab is given by an injection directly into the eye.

Ranibizumab (Lucentis) is a drug similar to bevacizumab. It may also be used to treat vision loss caused by damage to blood vessels from radiation therapy. Ranibizumab is given by an injection directly into the eye.

Tyrosine kinase inhibitors (TKIs) block chemicals called tyrosine kinases. These chemicals are part of the signalling process within cells. When this process is blocked, the cell stops growing and dividing.

Imatinib (Gleevec) is sometimes used to treat advanced intraocular melanoma. It is a pill that is taken by mouth (orally).

Sorafenib (Nexavar) is sometimes used to treat advanced intraocular melanoma. It is a pill that is taken by mouth.

Side effects can happen with any type of treatment for eye cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Targeted therapy attacks cancer cells but doesn’t usually damage healthy cells, so there are usually fewer and less severe side effects than chemotherapy or radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.

If you develop side effects, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of targeted therapy will depend mainly on the type of drug or combination of drugs, the dose, how it’s given and your overall health. Some common side effects of targeted therapy for eye cancer are:

• flu-like symptoms, such as fever and chills
• fatigue
• skin problems, including redness, itching and dryness
• nausea
• headaches
• low blood cell counts

Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about targeted therapy. To make the decisions that are right for you, ask your healthcare team questions about targeted therapy.