Ocular and Periocular Squamous Cell Carcinoma: Role of Immune Check Point Inhibitors

Area of Science:

• Oncology
• Ophthalmology
• Immunotherapy

Background:

• Periocular squamous cell carcinoma (SCC) with orbital invasion or perineural spread (PNS) presents significant treatment challenges.
• Traditional treatments like surgery and radiation can lead to disfigurement and vision loss.

Purpose of the Study:

• To evaluate the efficacy of immune checkpoint inhibitors (ICIs), specifically PD-1 inhibitors, in managing advanced periocular SCC.
• To assess the potential of ICIs to reduce the need for radical surgical interventions and mitigate radiation-induced ocular toxicity.

Main Methods:

• The study focuses on the clinical outcomes of patients with periocular SCC treated with PD-1 inhibitors.
• Analysis of tumor response, surgical avoidance, and preservation of vision and ocular function.

Main Results:

• ICIs demonstrated significant tumor shrinkage in locally advanced periocular SCC with orbital invasion, potentially avoiding orbital exenteration.
• PD-1 inhibitors proved effective for SCC with PNS, serving as an alternative to high-dose orbital radiation, thereby preventing vision loss and ocular toxicity.
• Tumor shrinkage was observed in conjunctival SCC cases with high tumor mutation burden following PD-1 inhibitor treatment.

Conclusions:

• PD-1 inhibitors represent a major therapeutic advance for advanced periocular SCC, offering organ preservation and improved functional outcomes.
• ICIs provide a valuable treatment option for periocular SCC, particularly in cases involving orbital invasion, PNS, or high tumor mutation burden, improving patient prognosis and quality of life.