UVEAL MELANOMA: IMMUNOLOGIC STUDIES

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The biology of uveal malignant melanoma is complex. Recent conflicts in the literature have suggested that the standard enucleation technique may actually be disseminating tumor cells or reducing the patient's immunocompetence, causing metastatic disease. Because of this, some authors have gone so far as to suggest not enucleating a patient with uveal malignant melanoma. At the other extreme, some authors suggest the enucleation of every eye with a uveal melanoma, even if there is no detectable growth. This proposal will look at various immunological parameters in patients with uveal malignant melanoma presenting to the Wills Eye Hospital Oncology Service. The parameters to be studied include: tumor-associated antibodies (TAA) to cytoplasmic melanoma antigens in order to evaluate the prognostic significance of TAA levels. Cell-mediated immunocompetence testing will be performed by leukocyte adherence inhibition assay using melanoma extracts, lymphoblast transformation with various plant lectins, and direct leukocyte migration inhibition in the presence of melanoma extracts. T-lymphocyte subsets will be examined by rosette formation and commercially available monoclonal antibodies. Inflammatory cells will be examined in fresh tumor tissue using monoclonal antibodies and histo-chemical techniques. Patients with uveal melanoma will have their histo-compatability-HLA type examined to see if there are increased incidences of certain HLA types in those patients who develop metastases when compared to those patients who remain tumor-free. Finally, ocular fluids and tumor tissue obtained at the time of enucleation, will be examined for the presence of tumor angiogenesis factor using in vivo and in vitro techniques. These techniques will be evaluated to find prognostic tests for detecting these patients who will go on to develop metastases.