In 31 cases, therefore, it was possible to examine the whole tumour for changes caused by the biopsy and to compare the typing of the biopsy with that of the whole tumour. In the irradiated eyes histologically viable tumour cells remained mostly in the inner part of the tumour. Scleral necrosis was not found. The technique used appears to be safe. Histological verification is highly recommended before any conservative therapy, inter alia to obtain true statistics of therapeutic results.
Uveal melanoma has a high mortality rate and responds poorly to existing chemotherapy.
We have therefore examined the sensitivity of uveal melanoma to cytotoxic agents using an ex vivo chemosensitivity assay to determine whether some agents which have not been used for this tumor might have activity. No tumors were sensitive to temozolomide, or 5-fluorouracil, and only one of 14 to vincristine. The combination of treosulfan with cytosine arabinoside resulted in enhanced tumor cell inhibition in three of five tumors tested. Uveal melanoma shows considerable heterogeneity of sensitivity to cytotoxic drugs, with considerable resistance to most agents, matching clinical experience. The results suggest that cytosine arabinoside or gemcitabine plus treosulfan may be an active combination.