News Releases

July 31, 2001

Emory Eye Center researcher finds similar survival rates for eye cancer therapies: Research Also Increases Nationwide Availability of Treatments

Media contacts: Joy H. Bell, 404-778-3711, jbell@emory.edu
Kathi Ovnic, 404-727-9371, covnic@emory.edu
Janet Christenbury, 404-727-5899, jmchris@emory.edu
ATLANTA – The National Eye Institute (NEI) has issued important research results stating that survival rates for two alternative treatments for primary eye cancer—radiation therapy and removal of the eye—are about the same. Emory Eye Center’s Paul Sternberg, Jr., M.D., was a primary investigator in the nationwide study, with results announced July 12. The clinical trial—called the Collaborative Ocular Melanoma Study (COMS)––was conducted at 43 institutions, including medical schools, hospitals, and doctors' offices, throughout the United States and Canada. The COMS trial was supported by the NEI and the National Cancer Institute (NCI), components of the National Institutes of Health (NIH). Prior to these findings, it was not known which treatment could result in lower mortality rates. Additionally, as a result of the study, the capability of doctors to provide more accurate diagnoses and state-of-the-art treatments for eye cancer has been greatly expanded, the findings report. Mortality data from the two treatments are compared in the July 2001 issue of Archives of Ophthalmology.

"This study will have a major impact on treatment for patients with eye cancer,” says Dr. Sternberg. “First, it demonstrated that we can treat this tumor effectively with radiation, and not have to remove the eye. Second, we were thrilled with the improved life expectancy in this study—an 82 percent five-year survival—suggesting that the skilled treatment and compulsive follow-up required by this study are critical to a successful outcome. The results of this study give us renewed optimism for patients with ocular melanoma," he states.

NCI’s director Richard Klausner has said that "The COMS findings are a striking example of the role that clinical trials play in improving patient care. Without this important trial, patients would not have known that they have a choice between radiation and surgery for treatment of their ocular melanoma, with the same opportunity for long-term survival." With the data showing similar survival rates for radiation therapy vs. removal of the eye, quality of life issues become important factors when deciding which of the two treatment options is better for the individual patient, the findings conclude.

BACKGROUND:

For more than a century, removal of the eye has been the standard treatment for primary eye cancer, also known as ocular melanoma. During the past 25 years, interest in radiation therapy has increased because of the potential for saving the eye –– and with it, some vision. In the COMS, patients with medium-sized tumors were studied in a randomized clinical trial to determine which of two treatments––radiation therapy or removal of the eye––is more likely to prolong survival. The affected eyes of one group received a form of radiation therapy called I-125 brachytherapy, in which a small plaque containing radioactive iodine pellets is placed over the tumor. The other group had the eye removed.

Approximately one-third of the patients have been followed for 10 years; over 80 percent were followed for five years. Researchers found that the survival rates were essentially the same in the two groups.

In the COMS clinical trial, researchers also found that the five-year survival rate of patients who were treated with either radiation therapy or eye removal was 82 percent, considerably better than the 70 percent five-year survival rate that had been projected when the study was designed in 1985. Moreover, there is no evidence that either treatment causes harm to the other eye. All patients in the study will continue to be followed for up to 15 years.

The type of eye cancer studied by COMS researchers is choroidal melanoma, a tumor of the eye that arises from pigmented cells of the choroid, a layer of tissue in the back of the eye. Although it is rare, choroidal melanoma is the most common primary eye cancer in adults. These tumors enlarge over time and may lead to vision loss. More importantly, these tumors can spread, or metastasize, to other parts of the body; once metastasis is clinically detected, death typically occurs within months. Because there is no cure for metastatic melanoma, treatment is aimed at keeping the cancer confined to the eye.

Researchers estimate that between 1600 and 2400 new cases of ocular melanoma are diagnosed annually in the United States and Canada, a rate of about six to eight new cases per million people each year. Choroidal melanoma is much more common in whites of northern European descent.

The National Eye Institute (NEI) and the National Cancer Institute (NCI) are both part of the National Institutes of Health (NIH). The NEI is the federal government's lead agency for vision research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NCI is the federal government's primary agency for cancer research. The NIH is an agency of the U.S. Department of Health and Human Services.

The Emory Eye Center has been ranked in the top ten eye hospitals for three years in a row in U.S. News & World Report’s rankings, most recently published on July 23, 2001.

Media Contact: Joy H. Bell, jbell@emory.edu, 404-778-3711

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