Cemiplimab for Orbital Squamous Cell Carcinoma in 11 Cases

Steren, Benjamin; Burtness, Barbara; Bhatia, Aarti; Demirci, Hakan; Shinder, Roman; Yoo, David; Tse, Brian C.; Pointdujour-Lim, Renelle

doi:10.1097/iop.0000000000002190

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Four patients with high tumor mutation burden (60 Mut/Mb) showed complete and durable response after a mean follow-up of 6 months, while 1 patient with low tumor mutation burden (8.1 Mut/Mb) failed. Later, Steren et al 8 reported similar results with cemiplimab for the treatment of cSCC with orbital involvement in 11 patients. Nine of 11 (82%) patients demonstrated complete response without any significant side effects.…”

Section: Discussionmentioning

confidence: 80%

Use of Cemiplimab, an Immune Checkpoint Inhibitor for Conjunctival Intraepithelial Neoplasia

Ceylanoglu,

Eisenberg,

Worden

et al. 2024

Cornea

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Purpose: Immune checkpoint inhibitors (ICIs) have been recently introduced for the treatment of locally unresectable conjunctival squamous cell carcinoma. We present 2 cases with conjunctival intraepithelial neoplasia (CIN) who were treated with ICIs. Methods: A report of 2 cases with CIN who were treated with systemic cemiplimab (350 mg IV every 3 weeks). Results: A 70-year-old man was treated with cemiplimab for metastatic cutaneous squamous cell carcinoma. The pre-existing CIN continued to progress over the nasal bulbar conjunctiva and cornea, while the other metastatic sites, including parotid glands, and neck lymph nodes showed a complete response after 16 cycles of treatment. An 84-year-old woman had bilateral diffuse CIN involving bulbar and lower eyelid palpebral conjunctiva. Cemiplimab was started because of the extent of involvement. While the bulk of CIN was reduced, it progressed over the cornea and forniceal conjunctiva on OU after 10 cycles of treatment. Excisional biopsies of conjunctival lesions after cemiplimab confirmed CIN in both patients. Conclusions: Although conjunctival squamous cell carcinoma tumors are reported to be highly responsive to ICIs, a similar effect has not been observed in 2 patients with CIN. Further studies are needed to evaluate ICIs in the management of CIN.

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Section: Discussionmentioning

confidence: 80%

Use of Cemiplimab, an Immune Checkpoint Inhibitor for Conjunctival Intraepithelial Neoplasia

Ceylanoglu,

Eisenberg,

Worden

et al. 2024

Cornea

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“…12 Hoffmann et al 13 reported on a patient with advanced cSCC who received treatment with cemiplimab and showed stable disease (SD) that did not progress for a 19-month follow-up. Steren et al 15 reported 11 orbital SCC patients who were treated with cemiplimab, although it was not specifically mentioned how many of these patients were cSCC. Nine of 11 (82%) patients demonstrated CR without any significant side effects after a mean follow-up of 14.9 months.…”

Section: Conjunctival Squamous Cell Carcinomamentioning

confidence: 99%

Targeted Therapy and Immunotherapy for Advanced Malignant Conjunctival Tumors: Systematic Review

Serbest Ceylanoglu,

Guneri Beser,

Singalavanija

et al. 2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

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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.

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“…Five of these patients went on to surgery after achieving a clinical response and the other two who had extensive prior surgery and radiation achieved a complete response without further treatment ( 65 ). A series of 11 patients with orbital SCC that would require exenteration were treated with cemiplimab and 9/11 (82%) had a CR without need for surgery, with only one patient progressing on cemiplimab and another patient entering hospice for a second cancer ( 66 ). The largest such study of 13 patients in Israel of periocular SCC with orbital invasion treated with cemiplimab showed an overall response in 9/13 (69.2%) of patients with 7/13 (53.8%) achieving a CR.…”

Section: Squamous Cell Carcinoma Of the Skinmentioning

confidence: 99%

Review of recent advances in managing periocular skin malignancies

Trotier,

Huang,

van Landingham

et al. 2024

Front. Oncol.

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Management of cutaneous malignancies can be particularly challenging when they are located in the periocular region. The standard of care for localized disease is complete surgical excision, but this may not be possible without significant disruption to visual structures and facial appearance. Definitive radiation may be an option for some patients who cannot or do not wish to undergo surgery. Advances in systemic treatment options for locally advanced and metastatic skin cancers in the past 10 years have prompted investigation into neoadjuvant treatment of periocular cancers. The use of chemotherapy, immune checkpoint inhibitors, and targeted therapies have all been reported with varying degrees of success. For many patients, targeted therapies or immune checkpoint inhibitors should be considered depending on the cancer type, symptoms, and goals with the input of a multidisciplinary cancer care team. In this article, we systematically review the latest updates in surgical, radiotherapeutic, and medical management of periocular malignancies.

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Cemiplimab for Orbital Squamous Cell Carcinoma in 11 Cases

Cited by 6 publications

References 27 publications

Use of Cemiplimab, an Immune Checkpoint Inhibitor for Conjunctival Intraepithelial Neoplasia

Use of Cemiplimab, an Immune Checkpoint Inhibitor for Conjunctival Intraepithelial Neoplasia

Targeted Therapy and Immunotherapy for Advanced Malignant Conjunctival Tumors: Systematic Review

Review of recent advances in managing periocular skin malignancies

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