RETINOBLASTOMA TREATMENT PROTOCOLS: CURRENT STRATEGIES

Abstract

Retinoblastoma is the leading malignant intraocular tumor of childhood, with a prognosis directly related to early diagnosis and appropriate therapeutic management. Recent advances in the molecular understanding of the disease highlight the central role of RB1 gene inactivation and, to a lesser extent, MYCN amplification, with a significant impact on diagnosis, prognosis, and genetic counseling (NAG; KHETAN, 2024). Liquid biopsy of the aqueous humor has emerged as a safe alternative to conventional tumor biopsy, allowing the detection of circulating tumor DNA and the identification of relevant genomic alterations, with applications in diagnosis, prognostic stratification, and monitoring of therapeutic response (DAS et al., 2023; MUNIYANDI et al., 2024). In the therapeutic field, intravitreal chemotherapy has established itself as an effective strategy in controlling vitreous severities, traditionally associated with a worse prognosis, presenting high rates of tumor control and ocular preservation, with an acceptable safety profile when rigorous protocols are adopted (KAUR et al., 2023; TANVEER et al., 2024). Therefore, the integration between molecular diagnosis and targeted local therapies represents a significant advance in the management of retinoblastoma, aligning with the principles of precision medicine.