CYSLTR2 and metastatic neoplasm: UMs carry mutually exclusive activating mutations in GNAQ, GNA11, PLCβ4, and CYSLTR2, encompassing more than 90% of UM patients.4,19, , -22 Bidard et al18 detected ctDNA in 84% of patients with UM with metastatic disease and found ctDNA levels to be an independent prognostic factor for both progression-free survival and overall survival.18 However, the presence and prognostic significance of ctDNA in patients with primary UM without detectable metastatic disease has yet to be evaluated.