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Type 2 diabetes — UKMLA MCQ

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HardEndocrinologyType 2 diabetesUKMLAMRCGP AKTPARAMRCEM SBAMRCP Part 1PSA

A 55-year-old has unresectable metastatic uveal melanoma. HLA typing is positive for HLA-A*02:01. Which systemic treatment is specifically recommended by NICE for this biomarker-defined tumour?

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Correct answer: B — Offer tebentafusp under the advanced-uveal-melanoma pathway

The best answer is “Offer tebentafusp under the advanced-uveal-melanoma pathway”. Tebentafusp is recommended for adults with HLA-A*02:01-positive uveal melanoma that is unresectable or metastatic. The HLA result is therefore a treatment-selection biomarker rather than background information. Pembrolizumab, nivolumab with ipilimumab and dacarbazine may be encountered as systemic melanoma strategies, while trametinib is a targeted option in selected BRAF-pathway disease. None has the specific HLA-restricted NICE uveal-melanoma indication supplied by tebentafusp.

Reference: NICE TA1027, Tebentafusp for advanced uveal melanoma: https://www.nice.org.uk/guidance/ta1027/chapter/1-Recommendation