Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

Francis L. Munier, Maja Beck-Popovic, Guillermo L. Chantada, David Cobrinik, Tero T. Kivelä, Dietmar Lohmann, Philippe Maeder, Annette C. Moll, Angel Montero Carcaboso, Alexandre Moulin, Paula Schaiquevich, Ciara Bergin, Paul J. Dyson, Susan Houghton, Francesco Puccinelli, Yvan Vial, Marie-Claire Gaillard, Christina Stathopoulos

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Retinoblastoma is lethal by metastasis if left untreated, so the primary goal of therapy is to preserve life, with ocular survival, visual preservation and quality of life as secondary aims. Historically, enucleation was the first successful therapeutic approach to decrease mortality, followed over 100 years ago by the first eye salvage attempts with radiotherapy. This led to the empiric delineation of a window for conservative management subject to a “state of metastatic grace” never to be violated. Over the last two decades, conservative management of retinoblastoma witnessed an impressive acceleration of improvements, culminating in two major paradigm shifts in therapeutic strategy. Firstly, the introduction of systemic chemotherapy and focal treatments in the late 1990s enabled radiotherapy to be progressively abandoned. Around 10 years later, the advent of chemotherapy in situ, with the capitalization of new routes of targeted drug delivery, namely intra-arterial, intravitreal and now intracameral injections, allowed significant increase in eye preservation rate, definitive eradication of radiotherapy and reduction of systemic chemotherapy. Here we intend to review the relevant knowledge susceptible to improve the conservative management of retinoblastoma in compliance with the “state of metastatic grace”, with particular attention to (i) reviewing how new imaging modalities impact the frontiers of conservative management, (ii) dissecting retinoblastoma genesis, growth patterns, and intraocular routes of tumor propagation, (iii) assessing major therapeutic changes and trends, (iv) proposing a classification of relapsing retinoblastoma, (v) examining treatable/preventable disease-related or treatment-induced complications, and (vi) appraising new therapeutic targets and concepts, as well as liquid biopsy potentiality.
Original languageEnglish
JournalProgress in Retinal and Eye Research
Volume73
DOIs
Publication statusPublished - 1 Nov 2019

Cite this

Munier, Francis L. ; Beck-Popovic, Maja ; Chantada, Guillermo L. ; Cobrinik, David ; Kivelä, Tero T. ; Lohmann, Dietmar ; Maeder, Philippe ; Moll, Annette C. ; Carcaboso, Angel Montero ; Moulin, Alexandre ; Schaiquevich, Paula ; Bergin, Ciara ; Dyson, Paul J. ; Houghton, Susan ; Puccinelli, Francesco ; Vial, Yvan ; Gaillard, Marie-Claire ; Stathopoulos, Christina. / Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”. In: Progress in Retinal and Eye Research. 2019 ; Vol. 73.
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title = "Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”",
abstract = "Retinoblastoma is lethal by metastasis if left untreated, so the primary goal of therapy is to preserve life, with ocular survival, visual preservation and quality of life as secondary aims. Historically, enucleation was the first successful therapeutic approach to decrease mortality, followed over 100 years ago by the first eye salvage attempts with radiotherapy. This led to the empiric delineation of a window for conservative management subject to a “state of metastatic grace” never to be violated. Over the last two decades, conservative management of retinoblastoma witnessed an impressive acceleration of improvements, culminating in two major paradigm shifts in therapeutic strategy. Firstly, the introduction of systemic chemotherapy and focal treatments in the late 1990s enabled radiotherapy to be progressively abandoned. Around 10 years later, the advent of chemotherapy in situ, with the capitalization of new routes of targeted drug delivery, namely intra-arterial, intravitreal and now intracameral injections, allowed significant increase in eye preservation rate, definitive eradication of radiotherapy and reduction of systemic chemotherapy. Here we intend to review the relevant knowledge susceptible to improve the conservative management of retinoblastoma in compliance with the “state of metastatic grace”, with particular attention to (i) reviewing how new imaging modalities impact the frontiers of conservative management, (ii) dissecting retinoblastoma genesis, growth patterns, and intraocular routes of tumor propagation, (iii) assessing major therapeutic changes and trends, (iv) proposing a classification of relapsing retinoblastoma, (v) examining treatable/preventable disease-related or treatment-induced complications, and (vi) appraising new therapeutic targets and concepts, as well as liquid biopsy potentiality.",
author = "Munier, {Francis L.} and Maja Beck-Popovic and Chantada, {Guillermo L.} and David Cobrinik and Kivel{\"a}, {Tero T.} and Dietmar Lohmann and Philippe Maeder and Moll, {Annette C.} and Carcaboso, {Angel Montero} and Alexandre Moulin and Paula Schaiquevich and Ciara Bergin and Dyson, {Paul J.} and Susan Houghton and Francesco Puccinelli and Yvan Vial and Marie-Claire Gaillard and Christina Stathopoulos",
year = "2019",
month = "11",
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Munier, FL, Beck-Popovic, M, Chantada, GL, Cobrinik, D, Kivelä, TT, Lohmann, D, Maeder, P, Moll, AC, Carcaboso, AM, Moulin, A, Schaiquevich, P, Bergin, C, Dyson, PJ, Houghton, S, Puccinelli, F, Vial, Y, Gaillard, M-C & Stathopoulos, C 2019, 'Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”' Progress in Retinal and Eye Research, vol. 73. https://doi.org/10.1016/j.preteyeres.2019.05.005

Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”. / Munier, Francis L.; Beck-Popovic, Maja; Chantada, Guillermo L.; Cobrinik, David; Kivelä, Tero T.; Lohmann, Dietmar; Maeder, Philippe; Moll, Annette C.; Carcaboso, Angel Montero; Moulin, Alexandre; Schaiquevich, Paula; Bergin, Ciara; Dyson, Paul J.; Houghton, Susan; Puccinelli, Francesco; Vial, Yvan; Gaillard, Marie-Claire; Stathopoulos, Christina.

In: Progress in Retinal and Eye Research, Vol. 73, 01.11.2019.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Conservative management of retinoblastoma: Challenging orthodoxy without compromising the state of metastatic grace. “Alive, with good vision and no comorbidity”

AU - Munier, Francis L.

AU - Beck-Popovic, Maja

AU - Chantada, Guillermo L.

AU - Cobrinik, David

AU - Kivelä, Tero T.

AU - Lohmann, Dietmar

AU - Maeder, Philippe

AU - Moll, Annette C.

AU - Carcaboso, Angel Montero

AU - Moulin, Alexandre

AU - Schaiquevich, Paula

AU - Bergin, Ciara

AU - Dyson, Paul J.

AU - Houghton, Susan

AU - Puccinelli, Francesco

AU - Vial, Yvan

AU - Gaillard, Marie-Claire

AU - Stathopoulos, Christina

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Retinoblastoma is lethal by metastasis if left untreated, so the primary goal of therapy is to preserve life, with ocular survival, visual preservation and quality of life as secondary aims. Historically, enucleation was the first successful therapeutic approach to decrease mortality, followed over 100 years ago by the first eye salvage attempts with radiotherapy. This led to the empiric delineation of a window for conservative management subject to a “state of metastatic grace” never to be violated. Over the last two decades, conservative management of retinoblastoma witnessed an impressive acceleration of improvements, culminating in two major paradigm shifts in therapeutic strategy. Firstly, the introduction of systemic chemotherapy and focal treatments in the late 1990s enabled radiotherapy to be progressively abandoned. Around 10 years later, the advent of chemotherapy in situ, with the capitalization of new routes of targeted drug delivery, namely intra-arterial, intravitreal and now intracameral injections, allowed significant increase in eye preservation rate, definitive eradication of radiotherapy and reduction of systemic chemotherapy. Here we intend to review the relevant knowledge susceptible to improve the conservative management of retinoblastoma in compliance with the “state of metastatic grace”, with particular attention to (i) reviewing how new imaging modalities impact the frontiers of conservative management, (ii) dissecting retinoblastoma genesis, growth patterns, and intraocular routes of tumor propagation, (iii) assessing major therapeutic changes and trends, (iv) proposing a classification of relapsing retinoblastoma, (v) examining treatable/preventable disease-related or treatment-induced complications, and (vi) appraising new therapeutic targets and concepts, as well as liquid biopsy potentiality.

AB - Retinoblastoma is lethal by metastasis if left untreated, so the primary goal of therapy is to preserve life, with ocular survival, visual preservation and quality of life as secondary aims. Historically, enucleation was the first successful therapeutic approach to decrease mortality, followed over 100 years ago by the first eye salvage attempts with radiotherapy. This led to the empiric delineation of a window for conservative management subject to a “state of metastatic grace” never to be violated. Over the last two decades, conservative management of retinoblastoma witnessed an impressive acceleration of improvements, culminating in two major paradigm shifts in therapeutic strategy. Firstly, the introduction of systemic chemotherapy and focal treatments in the late 1990s enabled radiotherapy to be progressively abandoned. Around 10 years later, the advent of chemotherapy in situ, with the capitalization of new routes of targeted drug delivery, namely intra-arterial, intravitreal and now intracameral injections, allowed significant increase in eye preservation rate, definitive eradication of radiotherapy and reduction of systemic chemotherapy. Here we intend to review the relevant knowledge susceptible to improve the conservative management of retinoblastoma in compliance with the “state of metastatic grace”, with particular attention to (i) reviewing how new imaging modalities impact the frontiers of conservative management, (ii) dissecting retinoblastoma genesis, growth patterns, and intraocular routes of tumor propagation, (iii) assessing major therapeutic changes and trends, (iv) proposing a classification of relapsing retinoblastoma, (v) examining treatable/preventable disease-related or treatment-induced complications, and (vi) appraising new therapeutic targets and concepts, as well as liquid biopsy potentiality.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85067097980&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31173880

U2 - 10.1016/j.preteyeres.2019.05.005

DO - 10.1016/j.preteyeres.2019.05.005

M3 - Review article

VL - 73

JO - Progress in Retinal and Eye Research

JF - Progress in Retinal and Eye Research

SN - 1350-9462

ER -