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Updated: Aug 6, 2026
Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Immune Checkpoint Inhibitors for Advanced Periocular/Orbital Squamous Cell Carcinoma of Cutaneous Origin: Durable
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.
Purpose:
This study's purpose was to investigate the outcomes of immune checkpoint inhibitor (ICI) treatment of periocular cutaneous squamous cell carcinoma with orbital invasion.
Methods:
A retrospective review was performed of 19 patients with biopsy-confirmed, advanced periocular cutaneous squamous cell carcinoma with orbital invasion treated with ICIs at a single institution. Tumors of conjunctival, sinonasal, lacrimal sac, or indeterminate origin were excluded. Demographic and clinical features at presentation, duration (number of cycles) of ICI, and treatment response were analyzed.
Results:
Nineteen patients with periocular cutaneous squamous cell carcinoma with orbital invasion treated with ICI were identified. The median age at diagnosis was 74 (interquartile range, 67-78) years. Most patients were non-Hispanic White (95%, n=18) and male (68%, n=13). Eight patients (42%) had AJCC T4 disease. Median presenting logMAR visual acuity in the affected eye was 0.3 (0.2-0.8). Eighteen patients (95%) had orbital involvement, and 14 (74%) had perineural involvement. Thirteen (68%) were treated with cemiplimab and 5 (26%) with pembrolizumab, and 1 was transitioned to cemiplimab after progression on pembrolizumab. Patients received a median of 9 (interquartile range, 6-15) cycles. Nine patients (47%) had complete response, 6 (32%) had a partial response, 3 (16%) remained stable, and only 1 (6%) progressed on ICIs. No tumors recurred nor required exenteration by the end of the study period. The median follow-up time was 35 (interquartile range, 19-53) months.
Conclusions:
Immunotherapy demonstrated excellent, sustained clinical outcomes in periocular cutaneous squamous cell carcinoma with orbital invasion with low morbidity and mortality. A disease control rate of over 90% was achieved and sustained at a median follow-up of almost 3 years.
Insights
Immune checkpoint inhibitors (ICIs) show excellent outcomes for periocular cutaneous squamous cell carcinoma with orbital invasion. This immunotherapy approach achieved over 90% disease control with low morbidity and mortality in a recent study.
Area of Science:
- Oncology
- Ophthalmology
- Dermatology
Background:
- Periocular cutaneous squamous cell carcinoma (cSCC) with orbital invasion presents a significant treatment challenge.
- Advanced cSCC with orbital invasion historically has poor prognoses.
Purpose of the Study:
- To evaluate the efficacy and outcomes of immune checkpoint inhibitor (ICI) therapy for periocular cSCC with orbital invasion.
Main Methods:
- Retrospective review of 19 patients with biopsy-confirmed periocular cSCC and orbital invasion treated with ICIs.
- Analysis of patient demographics, clinical features, ICI treatment duration, and response.
- Exclusion of tumors from conjunctival, sinonasal, lacrimal sac, or indeterminate origins.
Main Results:
- Nineteen patients (median age 74) with periocular cSCC and orbital invasion received ICIs (cemiplimab or pembrolizumab).
- High response rates observed: 47% complete response, 32% partial response, 16% stable disease, 6% progression.
- Over 90% disease control rate achieved and sustained over a median follow-up of 35 months; no recurrences or need for exenteration.
Conclusions:
- ICI therapy offers excellent and durable clinical outcomes for periocular cSCC with orbital invasion.
- Treatment demonstrated a high disease control rate (>90%) with minimal morbidity and mortality.
- Immunotherapy represents a promising treatment modality for this advanced malignancy.
