Eyeworld

21 EW NEWS & OPINION January 2019 and has shown impressive response in rabbits," Dr. Shields said. "We are in Phase 1b safety trials and efficacy trials are to begin soon. We have treated seven patients at Wills Eye Hospital. We might be able to treat smaller and smaller tumors with this modality. This is a new era of mela- noma treatment and prevention." Melanoma metastasis are target- ed with immune modulated T-cells against cancer. Dr. Shields elucidat- ed, "We use this every week. It is a receptor that attaches itself to mela- noma cells and attracts T-cells to it, causing necrosis of the melanocyte. We are learning to use this together with checkpoint inhibitors for better results for uveal melanoma." Tumor biomarkers A biomarker is a measurable indi- cator of a biological condition or disease, used in the pharmacological industry to design targeted drugs. There are a number of known biomarkers in ocular oncology, just as the well known biomarkers that identify breast, ovarian, and colorec- tal cancers. "We test for all of the known biomarkers, but we do not have specific medications for all of them. Recognizing conjunctival tu- mors and understanding predispos- ing factors, biomarkers, and treat- ment strategies are vital to patient outcomes. 6 These are exciting times in oncologic ophthalmology," Dr. Shields said. EW References 1. Karp CL, et al. Treatment of conjunctival and corneal intraepithelial neoplasia with topical interferon alpha-2b. Ophthalmology. 2001;108:1093–8. 2. Shields CL, et al. Interferon for ocular surface squamous neoplasia in 81 cases: outcomes based on the American Joint Committee on Cancer classification. Cornea. 2013;32:248–56. 3. Abramson DH, et al. Treatment of retino- blastoma in 2015: agreement and disagree- ment. JAMA Ophthalmol. 2015;133:1341–7. 4. Svendsen FH, et al. Lymphoma of the eyelid – an international multicenter retrospective study. Am J Ophthalmol. 2017;177:58–68. 5. Shields CL, et al. Personalized prognosis of uveal melanoma based on cytogenetic profile in 1059 patients over an 8-year period: the 2017 Harry S. Gradle Lecture. Ophthalmology. 2017;124:1523–1531. 6. Shields CL, et al. Conjunctival tumors: review of clinical features, risks, biomark- Contact information Shields: carolshields@gmail.com ers, and outcomes – the 2017 J. Donald M. Gass Lecture. Asia Pac J Ophthalmol (Phila). 2017;6:109–120. Editors' note: Dr. Shields has financial interests with Aura Biosciences (Cam- bridge, Massachusetts). Strength. COMPLEX CASE MIX. RENOWNED CLINICIANS. DISTINGUISHED FACULTY. GLOBAL ENGAGEMENT. CUTTING-EDGE TECHNOLOGY. DIVERSE SURGICAL TRAINING. EYE-ONLY EMERGENCY ROOM. MENTORSHIP AND CAMARADERIE. 840 Walnut St., Philadelphia, PA 19107 willseye.org | 877.289.4557 Believing is Seeing *Based on a Doximity clinical reputation survey for 2018-2019. Voted #1 ophthalmology residency program in the United States. *

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