Uveal melanoma is a rare cancer that starts inside the eye. When it is found, the standard treatments come at a cost to vision: removing the eye (enucleation) or placing a radioactive plaque against it (plaque brachytherapy). A phase 2 trial is testing whether a pill taken first can shrink the tumor and make those treatments less damaging.
The drug and the trial
Darovasertib is an oral drug that blocks protein kinase C (PKC). About 95% of uveal melanomas carry mutations in genes called GNAQ or GNA11 that keep PKC switched on. In the OptimUM-09 trial, presented by Lauren Dalvin, MD, of Mayo Clinic at the 2026 American Academy of Ophthalmology meeting, patients took darovasertib twice daily before their planned treatment. As of the data cutoff, 95 patients had been treated.
What was reported
- Eye preservation. Among 42 evaluable patients who had been facing enucleation, 24 (57%) were able to keep the eye and receive radiation instead.
- Tumor shrinkage. 84% of patients in the enucleation group and 82% in the plaque group had some shrinkage.
- Lower radiation doses. In 70.3% of patients planned for plaque therapy, projected radiation to key structures such as the fovea, optic nerve or lens went down.
- Side effects. Most were low grade, such as diarrhea, nausea, fatigue and vomiting, but 26.3% had a grade 3 or higher event, and low blood pressure was among the serious ones.
What it means
No treatment is currently approved to shrink uveal melanoma before definitive therapy. These are early, single-arm results, and a randomized phase 3 trial (OptimUM-10) is under way. This is care that happens in specialized ocular oncology centers.
What you can do
- Have a dilated eye exam on schedule. Some eye tumors are found on routine exams before any symptoms.
- Report new flashes, floaters, a shadow in your vision or a change in a known freckle in the eye.
- If you are diagnosed, ask your ocular oncologist whether you qualify for a clinical trial.
Our office does not treat eye cancer. We refer patients to ocular oncology specialists. Parents who want to understand eye health for younger family members can visit a children’s eye health resource.
I share this news because it gives patients and families real hope: the goal is no longer only saving a life, but saving the eye and its vision too.
Source: Neoadjuvant darovasertib preserves eyes in primary uveal melanoma (Ophthalmology Times, 10/10/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.