Personalized treatment concepts in extraocular cancer.

Adv Ophthalmol Pract Res

Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße, Cologne, Germany.

Published: March 2024

AI Article Synopsis

  • The periocular skin is highly susceptible to both benign and malignant tumors, with malignancies in this area being more aggressive and harder to treat compared to other skin regions.
  • Recent advancements in immunotherapy have enabled the immune system to effectively target and destroy cancer cells, particularly benefiting the treatment of periocular tumors.
  • The choice of treatment for periocular skin cancer should be individualized based on tumor type, size, and genetic factors, and may involve a combination of chemotherapy and immunotherapy options.

Article Abstract

Background: The periocular skin is neoplasms-prone to various benign and malignant. Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas. In recent decades, immunotherapy has significantly advanced oncology, allowing the autoimmune system to target and destroy malignant cells. Skin malignancies, especially periocular tumors, are particularly sensitive to immunotherapy. This technique has dramatically impacted the successful treatment of challenging tumors.

Main Text: Extraocular cancers, including eyelid (basal cell carcinoma, squamous cell carcinoma, melanoma, merkel cell carcinoma), conjunctival tumors (conjunctival melanoma, ocular surface squamous neoplasia) and other rare tumors, are unique and challenging clinical situations. Several genetic alterations associated with the pathogenesis of these diseases have been identified, and molecular mechanism are essential for the development of the immunotherapy agents, such as Hedgehog pathway inhibitors (vismodegib and sonidegib) for basal cell carcinoma, BRAF/MEK inhibitors (vemurafenib, dabrafenib, and encorafenib) for melanoma, and immune checkpoint inhibitors (Avelumab, pembrolizumab) for Merkel cell carcinoma.

Conclusions: The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures. Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type, tumor molecular profile, expected response rate, and candidacy for systemic treatment.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10999489PMC
http://dx.doi.org/10.1016/j.aopr.2024.02.003DOI Listing

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