Welcome to the CURE OM Forum, a community bulletin board designed to address the needs of the ocular melanoma community – patients and caregivers alike. Here you’ll find answers to questions about OM diagnosis and treatment, and support from people from all stages, levels of treatment and from all over the world. In addition to this forum, you can also visit the main discussion board on the Melanoma Patients Information Page (MPIP) and join the community on our CURE OM Facebook page.

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ThatHomeschoolDad's picture
Replies 1
Last reply 7/25/2012 - 7:24am
Replies by: RobC

Not for nothing, but if, as indicated at the Jeff conference, you want this to be a vibrant board and a realistic alternative to the Ocu-Mel list, you'll have to police spam.  You might also consider a new backend architecture that dramatically reduces the lag time after each submit.


Keep Rowing!

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Hey all,


Just read article where anti-pd-1 drugs work best in tumors with protein pd-L1?  Anyone know if ocular melanoma has this protein?  We were tested for gnaq/gna11 and do have gnaq mutation.  All help is welcomed.  We are starting mek trial with selumetinib next week.  Will let you know how that goes.  Margaret

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Hey all,


Just read article where anti-pd-1 drugs work best in tumors with protein pd-L1?  Anyone know if ocular melanoma has this protein?  We were tested for gnaq/gna11 and do have gnaq mutation.  All help is welcomed.  We are starting mek trial with selumetinib next week.  Will let you know how that goes.  Margaret

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eyecancerny's picture
Replies 6
Last reply 7/13/2012 - 4:46pm

Todays NY Times featured an article on the genetic testing for OM featuring Dr. Harbour.  Here's the link:

For those of us that attended the CURE OM conference there's nothing new here, but for others there's some valuable information.  

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We are still looking for an anti-pd-1 trial in nashville, atlanta, or close to chattanooga, tn.  Anybody know any that are in the works for 2012 or early 2013?  It looks like that bms would initiate more trials for ocular melanoma people who have progressed on yervoy as it seems the viable next step.  Please help us if you know of any.  thanks, Margaret Rogers

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We are still looking for an anti-pd-1 trial in nashville, atlanta, or close to chattanooga, tn.  Anybody know any that are in the works for 2012 or early 2013?  It looks like that bms would initiate more trials for ocular melanoma people who have progressed on yervoy as it seems the viable next step.  Please help us if you know of any.  thanks, Margaret Rogers

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lak's picture
Replies 19
Last reply 7/3/2012 - 11:28am


I am in the UK, I was diagnosed with OM 5 years ago and became stage IV with liver metastasis in May 2009. I am 53 now and never thought I would see 2012. I have had a hard time  in the National Health Service getting a proactive approach to my disease. In the beginning it was very lonely. Things are changing and now most clinicians admit to patients that the disease can spread outside the eye.  I am now looked after by excellent doctors who are prepared to answer my questions and inform me about my disease. I have been extremely lucky , my small choroidal melanoma was close to the fovea but Proton beam has enabled me to have better than 6/6(20/20) vision. I have had avastin vitrectomy and cataract ops too. My liver was looked after by a top MRI specialist who found my metastases very early. These were treated first with liver resections x2 then ipilimumab recurrences 6 months later SIRT sorted all but 2 of 18 metastasis throughout the liver. Microwave ablation sorted the last 2. The latter treatment was the hardest and completed in Dec I am only just getting fit again. My 5k time is embarrassingly slow but then many UK 53 year old females can not do 5k at all! I have added swimming and cycling too to my fitness regime to try and rest my joints a bit. My latest scans are all clear of disease. I have plans to run a 10k and maybe a half marathon- but also a SCUBA trip to the Maldives. I have only had  surgery.ipilimumab and radiation for treatments no actual chemotherapy .I am writing this post because I think it is so important that we all unite and share information both between patients and doctors but also across the table.

I accessed treatments because I was informed. In 2007 if you had a poor diagnosis it generally was not thought wise for a patient like me to be informed. I was empowered to get myself informed by an American Charity (Lance Armstrong Foundation) and I owe them the time I have gained. I then met other patients through the internet and Sara and learned through others experiences and "Google" . Many US doctors have seen my scans at various times and advised me. Several times I have been on the verge of traveling to the US for treatment only to be able to access treatment in the UK. For some reason it is easier to find out "who does what" in the US than it is in the UK. I profusely thank all the US doctors who have responded to my emails over the last 5 years it gave me so much support and ideas.  I hope by supporting CureOm and sharing across the pond that situation will change.

Reading Tom's post brought back so many memories of that first year post diagnosis- I really don't think I slept more than 15 minutes at a time for a whole year. For people with a new diagnosis I really want to tell them that even if the worst happens its not all bad. For those of you who have developed metastatic disease like me - yes its not always easy. For those carers who have lost their loved one - I am so sorry- but I thank you so much for continuing to be here and fighting for a cure for us. To the doctors who treat us I m sorry we are sometimes angry and you guys get in the firing line, I m sorry we don't often do well - it must be a hard disease to watch as a clinician over a career.

To all of those involved patents, carers and doctors sharing information and experiences from around the world has contributed to my disease free status- I am sure if team working across specialties and doctor patient relationships can be built on across the globe then a cure will be found for this disease.

Carpe diem


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It looks like substantially inhibiting the (re)activation of the stem cells of cancers is now possible by inhibiting the NOTCH pathways.


It was just done with leukemia in animals using a monoclonal antibody. The leukemia initiating cells did not survive. They were able, not only to get rid of cancerous cells, but also of the dormant stem cells starting it all.


I quote from the news release at UC San Diego:

Date: July 02, 2012 

Researchers Block Pathway to Cancer Cell Replication

NOTCH1 Signaling Promotes T-Cell Acute Lymphoblastic Leukemia-Initiating Cell Regeneration

Research suggests that patients with leukemia sometimes relapse because standard chemotherapy fails to kill the self-renewing leukemia initiating cells, often referred to as cancer stem cells.  In such cancers, the cells lie dormant for a time, only to later begin cloning, resulting in a return and metastasis of the disease.

One such type of cancer is called pediatric T cell acute lymphoblastic leukemia, or T-ALL, often found in children, who have few treatment options beyond chemotherapy.

A team of researchers – led by Catriona H. M. Jamieson, MD, PhD, associate professor of medicine at the University of California, San Diego School of Medicine and director of Stem Cell Research at UC San Diego Moores Cancer Center – studied these cells in mouse models that had been transplanted with human leukemia cells. They discovered that the leukemia initiating cells which clone, or replicate, themselves most robustly activate the NOTCH1 pathway, usually in the context of a mutation.

Earlier studies showed that as many as half of patients with T-ALL have mutations in the NOTCH1 pathway – an evolutionarily conserved developmental pathway used during differentiation of many cell and tissue types.  The new study shows that when NOTCH1 activation was inhibited in animal models using a monoclonal antibody, the leukemia initiating cells did not survive.  In addition, the antibody treatment significantly reduced a subset of these cancer stem cells (identified by the presence of specific markers, CD2 and CD7, on the cell surface).

“We were able to substantially reduce the potential of these cancer stem cells to self-renew,” said Jamieson.  “So we’re not just getting rid of cancerous cells: we’re getting to the root of their resistance to treatment – leukemic stem cells that lie dormant.”

The study results suggest that such therapy would also be effective in other types of cancer stem cells, such as those that cause breast cancer, that also rely on NOTCH1 for self-renewal. 

“Therapies based on monoclonal antibodies that inhibit NOTCH 1 are much more selective than using gamma-secretase inhibitors, which also block other essential cellular functions in addition to the NOTCH1 signaling pathway,” said contributor A. Thomas Look, MD of Dana-Farber/Children Hospital Cancer Center in Boston. “We are excited about the promise of  NOTCH1-specific antibodies to counter resistance to therapy in T-ALL and possibly additional types of cancer.”

In investigating the role of NOTCH1 activation in cancer cell cloning, the researchers showed that leukemia initiating cells possess enhanced survival and self-renewal potential in specific blood-cell, or hematopoietic, niches: the microenvironment of the body in which the cells live and self-renew.

The scientists studied the molecular characterization of CD34+ cells – a protein that shows expression in early hematopoietic cells and that facilitates cell migration – from a dozen T-ALL patient samples.

They found that mutations in NOTCH1 and other genes capable of promoting the survival of cancer stem cells co-existed in the CD34+ niche.  Mice transplanted with CD34-enriched NOTCH1 mutated T-ALL cells demonstrated significantly greater leukemic cloning potential than did mice without the NOTCH1 mutation.  The mutated cells were uniquely susceptible to targeted inhibition with a human monoclonal antibody, according to the scientists.

Additional contributors to the study include Wenxue Ma, Daniel J. Goff, Ifat Geron, Anil Sadarangani, Christina A. M. Jamieson, Angela C. Court, Alice Y. Shih, Qingfei Jiang, Christina C. Wu, Kristen M. Smith, Leslie A. Crews, Ida Deichaite, Sheldon R. Morris and Dennis A. Carson, UC San Diego Department of Medicine and Stem Cell Program, UC San Diego Moores Cancer Center; Alejandro Gutierrez, Dana-Farber/Children Hospital Cancer Center in Boston; and Kang Li, Ping Wei and Neil W. Gibson, Oncology Research Unit, Pfizer Global Research and Development, La Jolla Laboratories, San Diego."


Of course anyone with OM woudl be asking themselves if the NOTCH signaling pathways are also inportant in the proliferation of uveal melanoma (our cancer) stem cells. The answer is: YES! That was shown in a published study in February at Johns Hopkins. See


It looks like our researchers are zooming in closer and closer to deal with the real culprits of many cancers. The specific cancer stem cells are the factories that need to be shut down.


Can't wait for the trials starting on the NOTCH inhibitors. Hopefully our doctors will catch on with this and start NOTCH inhibitor trials with uveal melanoma patients.


Maybe you guys could start asking questions about this with your doctors to make it visible for them? Can't hurt asking.


Peter L in NH


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edamaser's picture
Replies 2
Last reply 7/3/2012 - 9:39am
Replies by: paperdetective, RobC

Combination Small Molecule MEK and PI3K Inhibition Enhances Uveal Melanoma Cell Death in a Mutant GNAQ and GNA11 Dependent Manner

  1. Jahan S. Khalili1,
  2. Xiaoxing Yu1,
  3. Ji Wang2,
  4. Brendan C. Hayes1,
  5. Michael A. Davies3,
  6. Gregory Lizee4,
  7. Bita Esmaeli5, and
  8. Scott E. Woodman6,*

+ Author Affiliations

  1. 1Melanoma Medical Oncology, MD Anderson Cancer Center

  2. 2Thoracic and Cardiovascular surgery, MD Anderson cancer Center

  3. 3Melanoma Medical Oncology and Systems Biology, M. D. Anderson Cancer Center

  4. 4Melanoma Medical Oncology, M.D. Anderson Cancer Center

  5. 5Head and Neck Surgery, Section of Ophthalmology, MD Anderson Cancer Center

  6. 6Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center
  1. *Corresponding Author:
    Scott E. Woodman, Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, South Campus Research Building, SCR 2.3022, 7455 Fannin St., Houston, TX, 77054, United States

Purpose: Activating-Q209L/P mutations in GNAQ or GNA11 (GNAQ/11) are present in ∼80% of uveal melanomas (UM). Mutant GNAQ/11 are not currently therapeutically targetable. Inhibiting key downstream effectors of GNAQ/11 represents a rational therapeutic approach for UMs that harbor these mutations. The MEK/MAPK and PI3K/AKT pathways are activated in UM. In this study, we test the effect of the clinically relevant small molecule inhibitors GSK1120212 (MEK inhibitor) and GSK2126458 (pan class I PI3K inhibitor) on UM cells with different GNAQ/11 mutations. Experimental Design: We use the largest set of genetically annotated uveal melanoma cell lines to-date to perform in vitro cellular signaling, cell cycle regulation, growth and apoptosis analyses. RNA interference and small molecule MEK and/or PI3K inhibitor treatment were employed to determine the dependency of cells with different GNAQ/11 mutation backgrounds on MEK/MAPK and/or PI3K/AKT signaling. Proteomic network analysis was performed to unveil signaling alterations in response to MEK and/or PI3K inhibition. Results: GNAQ/11 mutation status was not a determinant of whether cells would undergo cell cycle arrest or growth inhibition to MEK and/or PI3K inhibition. A reverse correlation was observed between MAPK and AKT phosphorylation after MEK or PI3K inhibition, respectively. Neither MEK nor PI3K inhibition alone was sufficient to induce apoptosis in the majority of cell lines; however, the combination of MEK + PI3K inhibitor treatment caused marked apoptosis in a GNAQ/11 mutant-dependent manner. Conclusions: MEK + PI3K inhibition may be an effective combination therapy in uveal melanoma given the inherent reciprocal activation of these pathways in UM.

  • Received December 14, 2011.
  • Revision received May 30, 2012.
  • Accepted June 1, 2012.
  • Copyright © 2012, American Association for Cancer Research. 

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ThatHomeschoolDad's picture
Replies 8
Last reply 6/26/2012 - 5:33pm

I'm not talking about studies -- that's another topic and then some.  I mean articles, online or print, that should be in the Welcome Basket for any new OM patient.  What must-reads have you found?  I'll start us off:


CURE Today article on super survivors, that is, "terminal" patients who are re-writing the odds.  Does not discuss OM, but useful anyway:


The Median Isn't the Message, the smartest, most thoughtful essay ever on statistics. A must for anyone Googling their disease.  Should be a laminated handout in every oncologist's office:


Postcards From Beyond the Zero, another great one from's Statistics section.  Actually, the whole Statistics section is a must-read:

Keep Rowing!

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Shelby - MRF's picture
Replies 1
Last reply 6/26/2012 - 5:29pm
Replies by: ThatHomeschoolDad

Posted on behalf of edamaser:

Delayed Systemic Recurrence of Uveal Melanoma
Kolandjian, Nathalie A. BA; Wei, Caimiao PhD; Patel, Sapna P. MD; Richard, Jessica L. ANP; Dett, Tina FNP; Papadopoulos, Nicholas E. MD; Bedikian, Agop Y. MDAbstract

Context: Metastatic uveal melanoma recurrence after >=10 years is not well studied in the clinical literature. This study describes the clinical characteristics and natural history of patients with delayed tumor recurrence.

Objective: To describe the characteristics of patients with delayed systemic recurrence of uveal melanoma and the natural history of the disease after recurrence.

Evidence Acquisition: This is a chart review of patients treated between 1994 and 2008 at The University of Texas, MD Anderson Cancer Center for uveal melanoma whose disease recurred >=10 years after treatment of the primary tumor.

Results: Of 463 patients treated for metastatic uveal melanoma, 305 developed systemic recurrence within 5 years from the time of diagnosis of primary melanoma, 97 developed systemic recurrences between 5 and 10 years, whereas 61 patients developed metastasis after >=10 years. The interval between primary to first systemic metastasis was a significant independent predictor of survival time from first systemic metastasis. The median survival time for patients with delayed metastatic recurrence after >=10 years was significantly longer than for patients who had intermediate or early systemic recurrence. Levels of lactate dehydrogenase, serum alkaline phosphatase, serum albumin, age, M-stage, and performance status at time of recurrence, as well as sex were also independent predictors of survival time from systemic recurrence.

Conclusions: Longer time interval between primary and first systemic metastasis is significantly correlated with prolonged survival. Patients who survive >=10 years without tumor metastasis after treatment for primary uveal melanoma cannot be considered cured. Prognosis remains poor for patients with metastatic uveal melanoma.

(C) 2012 Lippincott Williams & Wilkins, Inc. 

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On Sunday, August 12th, lace up your sneakers and join the Melanoma Foundation of New England at the starting line for the 2012 New Balance Falmouth Road Race. You can help spread awareness and educate others in the fight against melanoma.

Runners have been raising funds and awareness for the Melanoma Foundation of New England since 2004. Running for Cover, the Foundation's running team, has been running Falmouth for the past four years. We aim to raise more than $15,000 this year! Runner will be required to raise a minimum of $1,000 to help us reach our goal.

If you, or someone you know, is interested in joining Running for Cover, please visit our website, apply online, or email

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When you have been recently diagnosed with ocular melanoma, I believe there is nothing more inspirational to help one deal with it than Steve Job's (Apple's new deceased CEO) 2005 Stanford commencement speech, just after he was diagnosed with pancreatic cancer.

The video is heer

The text is here

And if you want more inspiring details on Steve Jobs, I recommend the approved biography by Walter Isaacson.


Peter L in NH

diagnosed jan 2012, biopsied class 1b cells feb 2012,  proton beamed feb 2012, currently no mets, central vision on tumor eye virtually gone, vision in other (lazy) eye also part compromised

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ThatHomeschoolDad's picture
Replies 2
Last reply 6/23/2012 - 8:25am
Replies by: eyecancerny, RobC

What a great conference in Philly.  Now I'm all revved up!  Anyway...

For those of us who chatted afterward, and for anyone else who'd like the info, here some links I mentioned regarding talking to kids about cancer:

YouTube BBC animated series on the body -- Search for "Once upon a time in the body" or go to the member page of the one user who seems to have uploaded nearly the whole series --

 It is, as they say, absolutely brilliant.  Also free. -- Search on "cancer" and you'll get two or three good animated vids for kids.  You may have to sign up for the free trial to access it.  I’d post the vids, but they are embedded Flash.

I thought there might be one link for Gilda’s Club, but each chapter seems to have its own site, so you’ll have to Google based on your location.  The Wellness Community, which at least in NJ has merged with Gilda’s, does have a single national site, from which you can find local chapters:

We go to the parent / kids group Wellness runs in NJ, and it’s super.

The other resource to ask for at your local cancer center or hospital is a Child Life Specialist.   If she’s a Certified Play Therapist, all the better.  If not, try anyway.  If your hospital doesn't have one, look elsewhere.

Seriously, do it.

Monday would be good.

I'm still poking around for more.  Will post under this topic as acquired.


Keep Rowing!

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margaretrogers57's picture
Replies 1
Last reply 6/19/2012 - 12:54pm
Replies by: paperdetective

Dear  Friends,


My husband has had ipi and gm-csf in trial.  Showed progression although small in some mm sized tumors.  We went to y-90 next.  2 1/2 months after rt. and a month after left lobe treated, tumors were significantly bigger.  Also some bone mets appeared. Talking about Temoolomide or azd6244 trial @ vanderbilt or pd-1 drug @ moffitt.  Anyone out there that has done these?  Thanks, margaret

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