Document Type
Poster
Presentation Date
11-2026
Abstract
Background
Metastatic uveal melanoma (mUM) is a rare malignancy; up to 50% of patients with uveal melanoma develop systemic metastases, with liver involvement occurring in up to 90% of metastatic cases.1 Thomas Jefferson University Hospital has extensive experience managing liver-dominant mUM, supported by prior single-institution longitudinal data involving 730 patients with uveal melanoma liver metastasis.3 This mUM program represents a specialized referral model for complex liver-dominant disease, offering multidisciplinary review, advanced liver-directed treatment planning, and coordinated access to specialty oncology care. Oncology navigation facilitates this model by coordinating intake, acquisition of outside imaging and records, pre-travel case preparation, tumor board review, treatment planning, and follow-up care for geographically dispersed patients.
Objective
To describe a navigation-driven multidisciplinary tumor board model supporting national and international access to specialized evaluation and coordinated care for patients with mUM.
Methods
A descriptive operational review of the mUM Multidisciplinary Tumor Board at Thomas Jefferson University Hospital’s Sidney Kimmel Comprehensive Cancer Center was conducted during calendar year 2025. The program used a weekly virtual multidisciplinary tumor board supported by oncology navigation. Oncology nurse and patient navigators conducted intake screening, coordinated acquisition of outside medical records and imaging, and presented new cases for tumor board review. Patients were referred nationally and internationally for evaluation. Outside imaging and records were electronically obtained and reviewed prior to patient travel when able. Participating specialties included medical oncology, interventional radiology, radiology, including body MRI expertise, clinical trials/research teams, and oncology navigation. Recommendations were developed to determine candidacy for specialized therapies including chemoembolization, immunoembolization, and percutaneous hepatic perfusion (PHP), a specialized therapy available at select centers.2 Systemic treatment recommendations, including nivolumab/ipilimumab and tebentafusp for eligible HLA-A*02:01-positive patients, could frequently be coordinated locally when appropriate.1
Results
During 2025, 1,113 case reviews involving 347 unique patients were completed through the multidisciplinary tumor board, eight of whom resided outside of the United States. While the Mid-Atlantic corridor (Philadelphia, New York City, Baltimore/Washington, D.C., and Lancaster/York) represented the largest regional referral footprint, referrals also extended to Southeast Michigan, Southern California, South Florida, Upstate New York, Chicago, Austin, and the Dallas–Fort Worth region. Remote pre-travel review facilitated multidisciplinary assessment prior to in-person consultation, allowing many cases to be evaluated before patient travel to determine treatment candidacy. Patients appropriate for liver-directed therapies were frequently coordinated for clinic evaluation or treatment as early as the following week. Patients who were not candidates for these interventions often received systemic treatment recommendations that could be coordinated locally, reducing unnecessary travel burden while maintaining access to specialized multidisciplinary guidance. Oncology navigation remained central throughout the continuum of care by coordinating intake, imaging acquisition, tumor board presentation, treatment planning, and longitudinal follow-up.
Conclusion
A centralized, navigation-driven multidisciplinary tumor board model supported timely access to specialized rare cancer care for patients with mUM referred nationally and internationally. Remote pre-travel multidisciplinary review supported treatment triage, streamlined coordination of specialized liver-directed therapies, and reduced unnecessary travel burden while facilitating access to specialized multidisciplinary care.
References
1. Carvajal, R. D., Sacco, J. J., Jager, M. J., Eschelman, D. J., Olofsson Bagge, R., Harbour, J. W., Chieng, N. D., Patel, S. P., Joshua, A. M., & Piperno-Neumann, S. (2023). Advances in the clinical management of uveal melanoma. Nature Reviews Clinical Oncology, 20(2), 99–115. https://doi.org/10.1038/s41571-022-00714-1
2. Leung, S. S., Gonsalves, C. F., Orloff, M., Adamo, R. D., Lindenmeyer, C. C., & Eschelman, D. J. (2025). Percutaneous hepatic perfusion melphalan induced sinusoidal obstruction syndrome (Veno-Occlusive Disease) in a patient with metastatic uveal melanoma. Case Reports in Oncology, 18(1), 1153–1159. https://doi.org/10.1159/000547005
3. Seedor, R. S., Eschelman, D. J., Gonsalves, C. F., Adamo, R. D., Orloff, M., Amjad, A., Sharpe-Mills, E., Chervoneva, I., Shields, C. L., Shields, J. A., Mastrangelo, M. J., & Sato, T. (2020). An outcome assessment of a single institution’s longitudinal experience with uveal melanoma patients with liver metastasis. Cancers, 12(1), Article 117. https://doi.org/10.3390/cancers12010117
Recommended Citation
Lynch, RN, Jameson, "Improving Access to Specialized Rare Cancer Care Through a Navigation-Driven Centralized Metastatic Uveal Melanoma Multidisciplinary Tumor Board" (2026). Kimmel Cancer Center Papers, Presentations, and Grand Rounds. Paper 88.
https://jdc.jefferson.edu/kimmelgrandrounds/88
Language
English
Comments
Presented at the 2026 Academy of Oncology Nurse & Patient Navigators (AONN+) Annual Conference.