This is a Phase 3, randomized, multi-center, open-label study of neoadjuvant darovasertib in subjects with primary non-metastatic uveal melanoma (OptimUM-10)

The study is divided into 2 cohorts of patients with primary uveal melanoma requiring either plaque brachytherapy or enucleation.

In cohort 1, patients in the treatment arm will receive neoadjuvant darovasertib followed by plaque brachytherapy compared to immediate plaque brachytherapy (control arm).

In cohort 2, the treatment arm will receive neoadjuvant darovasertib followed by definitive primary local therapy (i.e., plaque brachytherapy, proton beam radiation, or enucleation). Subjects in the control arm will go onto immediate enucleation.

Subjects will then receive primary local therapy following neoadjuvant darovasertib.

All patients will be followed for up to 3 years to assess longer term outcomes such as vision and tumor recurrence.

Inclusion Criteria:

• Primary non-metastatic uveal melanoma
• Able and willing to provide written, informed consent before initiation of any study-related procedures, and in the opinion of the Investigator, to comply with all study requirements
• ECOG 0 or 1
• Adequate organ function

Exclusion Criteria:

• Previous treatment for UM
• Evidence of metastatic UM
• Attributes that necessitate enucleation regardless of response to therapy
• Evidence of progressive secondary underlying ocular disease that would confound longitudinal VA assessments
• Presence of a malignant disease other than the one being treated in this study