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Published on: April 22, 2019
Targeted Therapy and Immunotherapy for Advanced Malignant Conjunctival Tumors: Systematic Review
Kubra Serbest Ceylanoglu1,2, Buse Guneri Beser1, Tassapol Singalavanija1,3
1Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, U.S.A.
Purpose:
To review the outcomes of targeted therapy and immunotherapy in advanced conjunctival tumors, including conjunctival squamous cell carcinoma, conjunctival melanoma, and conjunctival lymphoma.
Methods:
A Pubmed database systematic search was performed between January 1999 and December 2022. The literature search was limited to studies published in English.
Results:
This review included 142 patients with advanced malignant conjunctival tumors from 42 articles. In the conjunctival squamous cell carcinoma group, 2 cases of advanced conjunctival squamous cell carcinoma treated with epidermal growth factor receptor inhibitors showed significant tumor size improvement after 7.5 months of follow-up. Among 7 cases treated with systemic immunotherapy, 5 cases (72%) had complete response (CR), 1 case (14%) showed partial response (PR), and 1 case (14%) had stable disease (SD) after 16 months. In the conjunctival melanoma group, among 18 cases treated with combined v-raf murine sarcoma viral oncogene homolog B1/mitogen-activated extracellular signal-regulated kinase inhibitors, 6 (33%) had CR, 5 (28%) had PR, 2 (11%) had SD, and 5 (28%) had progressive disease after 24.8 months of follow-up. Of 44 conjunctival melanoma cases treated with immunotherapy, 12 (28%) had CR, 9 (20%) had PR, 7(16%) had SD, and 16 (36%) had progressive disease after 14.2 months. Systemic Rituximab treatment for conjunctival lymphoma cases resulted in CR in 21 patients (63%), PR in 11 patients (33%), and SD in 1 patient (3%) after 20.5 months of follow-up. Intralesional Rituximab injections in 38 conjunctival lymphoma cases showed CR in 28 patients (75%), PR in 7 patients (19%), SD in 1 patient (2%), and progressive disease in 2 patients (4%) after 20.4 months of follow-up.
Conclusions:
Despite limited clinical case reports and short-term follow-ups, targeted therapy and immunotherapy have shown promising results for advanced malignant conjunctival tumors.
Insights
Targeted therapy and immunotherapy show promise for advanced conjunctival tumors, including squamous cell carcinoma, melanoma, and lymphoma. These treatments offer significant response rates, with complete responses observed in many patients across different tumor types.
Area of Science:
- Ophthalmology
- Oncology
- Medical Research
Background:
- Advanced conjunctival tumors, such as squamous cell carcinoma, melanoma, and lymphoma, present significant treatment challenges.
- Limited data exists on the efficacy of modern systemic therapies for these rare malignancies.
- Understanding the outcomes of targeted therapy and immunotherapy is crucial for improving patient care.
Purpose of the Study:
- To systematically review the outcomes of targeted therapy and immunotherapy in patients with advanced conjunctival tumors.
- To evaluate treatment responses in conjunctival squamous cell carcinoma, conjunctival melanoma, and conjunctival lymphoma.
Main Methods:
- A systematic literature search was conducted in the Pubmed database from January 1999 to December 2022.
- Studies published in English were included.
- Data from 142 patients across 42 articles on advanced malignant conjunctival tumors were analyzed.
Main Results:
- Conjunctival squamous cell carcinoma showed improvement with epidermal growth factor receptor inhibitors and high response rates with systemic immunotherapy (72% complete response).
- Conjunctival melanoma demonstrated varied responses to BRAF/MEK inhibitors (33% CR) and immunotherapy (28% CR).
- Conjunctival lymphoma achieved high complete response rates with both systemic Rituximab (63%) and intralesional Rituximab (75%).
Conclusions:
- Targeted therapy and immunotherapy demonstrate encouraging efficacy in managing advanced malignant conjunctival tumors.
- Despite limitations in case reports and follow-up duration, these novel therapeutic approaches offer significant potential.
- Further research is warranted to optimize treatment strategies and long-term outcomes for these rare eye cancers.
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