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NCCN Flash Updates: NCCN Guidelines and NCCN Templates Updated for Melanoma: Uveal

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), the NCCN Drugs & Biologics Compendium (NCCN Compendium^®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), for Melanoma: Uveal. These NCCN Guidelines^® are currently available as Version 1.2025.

Link directly to the Updates section of the NCCN Guidelines: Melanoma: Uveal

UM-4

• Risk of Distant Metastasis
  • Low risk; 1st bullet revised: Class 1A or Class 1 PRAME (-)
  • Medium risk; 1st bullet revised: Class 1B or Class 1 PRAME (+)
• Footnote dd revised: Gene expression profile (GEP) class had a stronger independent association with metastasis than any other prognostic factor (P < .0001) (Onken MD, et al. Ophthalmology 2012;119:1596-1603). Elevated expression of PRAME (PRAME+) could be a risk modifier for metastasis in patients with either Class 1 or Class 2 uveal melanoma. PRAME expression is a marker for metastasis in Class 1 uveal melanoma tumors, and in Class 2 patients with PRAME expression may be associated with a shorter time to metastasis (Field MG, et al. Oncotarget 2016;7:59209-59219 Harbour JW, et al. J Clin Oncol 2024;42:3319-3329).
• Footnote ff revised:The most frequent site of metastasis is the liver; other sites include lungs, skin/soft tissue, and bones. For patients who elect to have surveillance imaging, options include: contrast-enhanced MRI (most sensitive), CT abdomen ± pelvis, or abdominal ultrasound of the liver, with modality preference determined by expertise at the treating institution. Additional imaging modalities may include chest/abdomen/pelvis CT with contrast, or chest x-ray Chest imaging can be done with CT chest without contrast, or chest x-ray.

UM-6

• After Workup, pathway bifurcations revised
  • Isolated liver metastases changed to Hepatic-dominant disease
  • Non-isolated liver metastases changed to Non–hepatic-dominant disease

UM-6A

• Footnote nn is new: The bulk of overall metastatic disease is confined to the liver.

UMSYS-1

• The following footnotes are new:
  • Footnote g: Nivolumab and hyaluronidase-nvhy is not approved for concurrent use with IV ipilimumab; however, for nivolumab monotherapy, nivolumab and hyaluronidase-nvhy subcutaneous injection may be substituted for IV nivolumab. Nivolumab and hyaluronidase-nvhy has different dosing and administration instructions compared to IV nivolumab.
  • Footnote h: Nivolumab and hyaluronidase-nvhy subcutaneous injection may be substituted for IV nivolumab. Nivolumab and hyaluronidase-nvhy has different dosing and administration instructions compared to IV nivolumab.

NCCN has published updates to the NCCN Chemotherapy Order Templates (NCCN Templates^®) for Melanoma: Uveal to reflect the currently published NCCN Guidelines^® for Melanoma: Uveal v1.2025.

• The following new template has been added:
  • UVMEL13: Nivolumab and hyaluronidase-nvhy

• Drug information notes for the following agents have been updated in the Chemotherapy Regimen, Supportive Care, Monitoring and Hold Parameters, and/or Safety Parameters and Special Instructions sections:
  • Albumin-bound PACLitaxel
  • CARBOplatin
  • Ipilimumab
  • Nivolumab
  • PACLitaxel
  • Pembrolizumab
  • Tebentafusp-tebn
  • Temozolomide
  • Trametinib

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium^®), the NCCN Biomarkers Compendium^®, the NCCN Chemotherapy Order Templates (NCCN Templates^®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients^®, please visit NCCN.org/patientguidelines.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.

About NCCN Flash Updates™

NCCN Flash Updates™ is a subscription service from NCCN that provides timely notification of updated and new information appearing in the NCCN Guidelines, the NCCN Compendium^®, and other NCCN Content.

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