Comparison Between Fotemustin to Intensive Surveillance in Patients With High Risk Uveal Melanoma

Inclusion Criteria:

1. High risk uveal melanoma, defined by :

   * Clinical criteria: Largest Tumor Diameter ≥ 15 mm with extrascleral extension and/or retinal detachment or Largest Tumor Diameter ≥ 18 mm AND/OR
   * Genomic high risk signature (cCGH +/- LOH) : Monosomy 3 or partial deletion of 3p and any 8 gain, from enucleation, transscleral or transvitreal samples
2. Age ≥ 18 years and ECOG Performance Status ≤ 2
3. No prior chemotherapy or history of invasive cancer \< 5years
4. No metastases
5. Local treatment for the primary tumour (surgery and/or radiotherapy) achieved ≤ 30 days from randomization, chemotherapy to begin within 15 days.

6 - Contraception in women of child-bearing potential

7- Written informed consent

8- Patients with French Social Security in compliance with the French law relating to biomedical research.

Non-Inclusion Criteria:

1. Largest Tumor Diameter \< 15 mm or Largest Tumor Diameter 15-18 mm without extrascleral extension and/or retinal detachment, in the absence of genomic alteration as defined per protocol or in the absence of Fine Needle Aspiration biopsy for genomic risk assessment.
2. Contraindication to Fotemustine administration
3. Hematological function : Hb \< 10g/dL, absolute neutrophil count \< 2,000/mm3, and platelets \< 100,000/mm3
4. Biochemistry results :Total bilirubin and AST/ALT \> 1,5 UNL (Upper Normal Limit)
5. Creatinine \> 1,5 UNL (Upper Normal Limit)
6. Pregnant and/or breastfeeding women.

8 - Previous history of cancer excepting in situ cervical carcinoma or cutaneous basal carcinoma.

7- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, viral or other hepatitis or cirrhosis, or psychiatric illness/social situation that would interfere with the protocol or limit compliance with study requirements.