PD-1 Inhibitors for Periocular Squamous Cell Carcinoma With Perineural Spread to the Orbit and Skull Base.

IF 1.2 4区 医学 Q3 OPHTHALMOLOGY
Tracy J Lu, Janet Fan, Luana Guimaraes de Sousa, Oded Sagiv, Sharia Hernandez, Lorena Bolanos Gomez, Neal Akhave, Renata Ferrarotto, Bita Esmaeli
{"title":"PD-1 Inhibitors for Periocular Squamous Cell Carcinoma With Perineural Spread to the Orbit and Skull Base.","authors":"Tracy J Lu, Janet Fan, Luana Guimaraes de Sousa, Oded Sagiv, Sharia Hernandez, Lorena Bolanos Gomez, Neal Akhave, Renata Ferrarotto, Bita Esmaeli","doi":"10.1097/IOP.0000000000002944","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Periocular squamous cell carcinoma with perineural spread and orbital and skull base involvement is challenging to treat, as complete surgical resection is usually not feasible and radiotherapy carries a high risk of ocular toxic effects. PD-1 inhibitors have emerged as an alternative treatment for such cases.</p><p><strong>Methods: </strong>A retrospective study of all consecutive patients with periocular squamous cell carcinoma and perineural spread to the orbit treated with PD-1 inhibitors was carried out. Patients who had concurrent radiotherapy were excluded. The main outcome measure was treatment response.</p><p><strong>Results: </strong>Most patients had recurrent squamous cell carcinoma that had been heavily treated with Mohs surgery, radiotherapy, chemotherapy, or a combination of these modalities before referral with perineural spread to the orbit and skull base. All patients had V1 involvement; other cranial nerves involved were III (n = 1), V2 (n = 1), V3 (n = 1), VI (n = 1), VII (n = 2), and VIII (n = 1). The PD-1 inhibitors cemiplimab and pembrolizumab were used in 9 patients and 1 patient, respectively. The treatment duration ranged from 2 to 24 months (median, 19 months). Six patients had a partial response, and 4 had a complete response. With a median follow-up time of 16 months, all patients were without evidence of progressive disease at last contact.</p><p><strong>Conclusion: </strong>Treatment with PD-1 inhibitors can lead to meaningful responses in patients with periocular squamous cell carcinoma with perineural spread to the orbit and skull base and avoids the need for radiotherapy, which is toxic to the eye. Careful long-term follow-up is needed to assess long-term response durability.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic Plastic and Reconstructive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IOP.0000000000002944","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Periocular squamous cell carcinoma with perineural spread and orbital and skull base involvement is challenging to treat, as complete surgical resection is usually not feasible and radiotherapy carries a high risk of ocular toxic effects. PD-1 inhibitors have emerged as an alternative treatment for such cases.

Methods: A retrospective study of all consecutive patients with periocular squamous cell carcinoma and perineural spread to the orbit treated with PD-1 inhibitors was carried out. Patients who had concurrent radiotherapy were excluded. The main outcome measure was treatment response.

Results: Most patients had recurrent squamous cell carcinoma that had been heavily treated with Mohs surgery, radiotherapy, chemotherapy, or a combination of these modalities before referral with perineural spread to the orbit and skull base. All patients had V1 involvement; other cranial nerves involved were III (n = 1), V2 (n = 1), V3 (n = 1), VI (n = 1), VII (n = 2), and VIII (n = 1). The PD-1 inhibitors cemiplimab and pembrolizumab were used in 9 patients and 1 patient, respectively. The treatment duration ranged from 2 to 24 months (median, 19 months). Six patients had a partial response, and 4 had a complete response. With a median follow-up time of 16 months, all patients were without evidence of progressive disease at last contact.

Conclusion: Treatment with PD-1 inhibitors can lead to meaningful responses in patients with periocular squamous cell carcinoma with perineural spread to the orbit and skull base and avoids the need for radiotherapy, which is toxic to the eye. Careful long-term follow-up is needed to assess long-term response durability.

PD-1抑制剂治疗眼眶和颅底神经周围扩散的眼周鳞状细胞癌。
背景:眼周鳞状细胞癌伴神经周围扩散,累及眼眶和颅底,治疗具有挑战性,因为完全的手术切除通常是不可行的,放射治疗有很高的眼毒性作用风险。PD-1抑制剂已成为此类病例的替代治疗方法。方法:对所有连续接受PD-1抑制剂治疗的眼周鳞状细胞癌伴神经周围扩散至眼眶的患者进行回顾性研究。同时进行放射治疗的患者被排除在外。主要结局指标为治疗反应。结果:大多数复发性鳞状细胞癌患者在转诊前曾接受Mohs手术、放疗、化疗或这些方式的联合治疗,并伴有神经周围扩散到眼眶和颅底。所有患者均有V1受累;其他受累脑神经为III神经(n = 1)、V2神经(n = 1)、V3神经(n = 1)、VI神经(n = 1)、VII神经(n = 2)、VIII神经(n = 1)。PD-1抑制剂cemiplimab和pembrolizumab分别用于9例和1例患者。治疗时间为2 ~ 24个月(中位19个月)。6名患者部分缓解,4名患者完全缓解。中位随访时间为16个月,所有患者在最后一次接触时均无疾病进展的迹象。结论:PD-1抑制剂治疗伴神经周围扩散至眼眶和颅底的眼周鳞状细胞癌患者可获得有意义的疗效,避免了对眼睛有毒性的放射治疗。需要仔细的长期随访来评估长期反应的持久性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.50
自引率
10.00%
发文量
322
审稿时长
3-8 weeks
期刊介绍: Ophthalmic Plastic and Reconstructive Surgery features original articles and reviews on topics such as ptosis, eyelid reconstruction, orbital diagnosis and surgery, lacrimal problems, and eyelid malposition. Update reports on diagnostic techniques, surgical equipment and instrumentation, and medical therapies are included, as well as detailed analyses of recent research findings and their clinical applications.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信