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Immunotherapy for Advanced Conjunctival Squamous Cell Carcinoma: Treatment Failures
Amee D Azad1, Jia Jia Zhang1, Kevin S Emerick2
1Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A.
Ophthalmic Plastic and Reconstructive Surgery
|March 13, 2025
Summary
Systemic immune checkpoint inhibitor (ICI) therapy showed disease progression in all five patients with advanced conjunctival squamous cell carcinoma (SCC). Low tumor mutational burden was observed in all cases, suggesting it may impact treatment response.
Area of Science:
- Ophthalmology
- Oncology
- Immunology
Background:
- Advanced conjunctival squamous cell carcinoma (SCC) is a rare malignancy.
- Systemic immune checkpoint inhibitors (ICIs) have shown promise in various cancers.
- Limited data exist on ICI efficacy for advanced conjunctival SCC.
Purpose of the Study:
- To evaluate the treatment response of advanced conjunctival SCC to systemic ICI therapy.
- To identify factors influencing ICI treatment outcomes in this patient cohort.
Main Methods:
- Retrospective review of five patients with advanced conjunctival SCC treated with ICIs (2015-2024).
- Inclusion criteria: orbital invasion, unresectable, or metastatic disease.
- Evaluation of computed tomography imaging and tumor mutational burden (TMB).
Main Results:
- All five patients experienced disease progression on ICI therapy.
- Three patients required exenteration within six months of diagnosis.
- One patient developed metastatic disease, and another had intracranial extension.
- All patients presented with low tumor mutational burden.
Conclusions:
- Contrary to previous reports, systemic ICI therapy demonstrated disease progression in all studied patients with advanced conjunctival SCC.
- Low tumor mutational burden may be associated with poor response to ICIs in conjunctival SCC.
- Further research with larger cohorts is necessary to elucidate the role of ICIs in conjunctival SCC management.
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