Precision Medicine in Eye Melanoma: Advancing Targeted Therapies and Personalized Care

Abstract: Eye melanoma, which includes uveal and conjunctival subtypes, is challenging to treat because it is highly metastatic and not particularly susceptible to standard therapeutic approaches. In this review, we examine the role of precision medicine in transforming disease management through genomic profiling, biomarker discovery, and nextgeneration sequencing. Targeted therapeutic development has focused on key oncogenic drivers such as GNAQ, GNA11, and BAP1, as well as signaling pathways including MAPK, PKC, and PI3K. Immunotherapy strategies, particularly tumour-infiltrating lymphocyte therapy and TCR-engineered T cells, are emerging as potential alternative treatments for resistant cases. Advances in liquid biopsy technologies, including circulating tumour DNA and exosome analysis, also enable real-time and non-invasive disease monitoring. This review summarizes recent developments, highlights progress in precisionbased interventions, and discusses existing challenges in clinical translation and ethical considerations. Overall, the findings underscore the importance of precision medicine as a key approach for advancing targeted therapies and personalized treatment strategies for eye melanoma.