New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?
The management of periocular skin malignant tumours is challenging. Surgery remains the mainstay of treatment for localised eyelid cancers. For more locally advanced cancers, especially those invading the orbit, orbital exenteration has long been considered the gold standard; however, it is a highly...
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doaj-a4969950c8974ce88bb37d036a2a989c2021-06-30T23:24:21ZengMDPI AGCancers2072-66942021-06-01132822282210.3390/cancers13112822New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?Arnaud Martel0Sandra Lassalle1Alexandra Picard-Gauci2Lauris Gastaud3Henri Montaudie4Corine Bertolotto5Sacha Nahon-Esteve6Gilles Poissonnet7Paul Hofman8Stephanie Baillif9Department of Ophthalmology, University Hospital of Nice, Cote d’Azur University, 06000 Nice, FranceFHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Cote d’Azur University, 06000 Nice, FranceDepartment of Dermatology, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, FranceDepartment of Oncology, Antoine Lacassagne Cancer Centre, 06000 Nice, FranceDepartment of Dermatology, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, FranceDepartment of Biology and Pathologies of Melanocytes, Team1, Equipe Labellisée Ligue 2020 and Equipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, Inserm, 06200 Nice, FranceDepartment of Ophthalmology, University Hospital of Nice, Cote d’Azur University, 06000 Nice, FranceCervicofacial Surgery Department, Antoine Lacassagne Cancer Centre, 06000 Nice, FranceFHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Cote d’Azur University, 06000 Nice, FranceDepartment of Ophthalmology, University Hospital of Nice, Cote d’Azur University, 06000 Nice, FranceThe management of periocular skin malignant tumours is challenging. Surgery remains the mainstay of treatment for localised eyelid cancers. For more locally advanced cancers, especially those invading the orbit, orbital exenteration has long been considered the gold standard; however, it is a highly disfiguring and traumatic surgery. The last two decades have been marked by the emergence of a new paradigm shift towards the use of ‘eye-sparing’ strategies. In the early 2000s, the first step consisted of performing wide conservative eyelid and orbital excisions. Multiple flaps and grafts were needed, as well as adjuvant radiotherapy in selected cases. Although being incredibly attractive, several limitations such as the inability to treat the more posteriorly located orbital lesions, as well as unbearable diplopia, eye pain and even secondary eye loss were identified. Therefore, surgeons should distinguish ‘eye-sparing’ from ‘sight-sparing’ strategies. The second step emerged over the last decade and was based on the development of targeted therapies and immunotherapies. Their advantages include their potential ability to treat almost all tumours, regardless of their locations, without performing complex surgeries. However, several limitations have been reported, including their side effects, the appearance of primary or secondary resistances, their price and the lack of consensus on treatment regimen and exact duration. The aim of this article was to review the evolution of the management of locally advanced periocular malignant tumours over the last three decades and highlight the new paradigm shift towards the use of ‘eye-sparing’ strategies.https://www.mdpi.com/2072-6694/13/11/2822periocular malignant tumoursorbital exenterationtargeted therapyimmunotherapyeye-sparing |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Arnaud Martel Sandra Lassalle Alexandra Picard-Gauci Lauris Gastaud Henri Montaudie Corine Bertolotto Sacha Nahon-Esteve Gilles Poissonnet Paul Hofman Stephanie Baillif |
spellingShingle |
Arnaud Martel Sandra Lassalle Alexandra Picard-Gauci Lauris Gastaud Henri Montaudie Corine Bertolotto Sacha Nahon-Esteve Gilles Poissonnet Paul Hofman Stephanie Baillif New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? Cancers periocular malignant tumours orbital exenteration targeted therapy immunotherapy eye-sparing |
author_facet |
Arnaud Martel Sandra Lassalle Alexandra Picard-Gauci Lauris Gastaud Henri Montaudie Corine Bertolotto Sacha Nahon-Esteve Gilles Poissonnet Paul Hofman Stephanie Baillif |
author_sort |
Arnaud Martel |
title |
New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? |
title_short |
New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? |
title_full |
New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? |
title_fullStr |
New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? |
title_full_unstemmed |
New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? |
title_sort |
new targeted therapies and immunotherapies for locally advanced periocular malignant tumours: towards a new ‘eye-sparing’ paradigm? |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2021-06-01 |
description |
The management of periocular skin malignant tumours is challenging. Surgery remains the mainstay of treatment for localised eyelid cancers. For more locally advanced cancers, especially those invading the orbit, orbital exenteration has long been considered the gold standard; however, it is a highly disfiguring and traumatic surgery. The last two decades have been marked by the emergence of a new paradigm shift towards the use of ‘eye-sparing’ strategies. In the early 2000s, the first step consisted of performing wide conservative eyelid and orbital excisions. Multiple flaps and grafts were needed, as well as adjuvant radiotherapy in selected cases. Although being incredibly attractive, several limitations such as the inability to treat the more posteriorly located orbital lesions, as well as unbearable diplopia, eye pain and even secondary eye loss were identified. Therefore, surgeons should distinguish ‘eye-sparing’ from ‘sight-sparing’ strategies. The second step emerged over the last decade and was based on the development of targeted therapies and immunotherapies. Their advantages include their potential ability to treat almost all tumours, regardless of their locations, without performing complex surgeries. However, several limitations have been reported, including their side effects, the appearance of primary or secondary resistances, their price and the lack of consensus on treatment regimen and exact duration. The aim of this article was to review the evolution of the management of locally advanced periocular malignant tumours over the last three decades and highlight the new paradigm shift towards the use of ‘eye-sparing’ strategies. |
topic |
periocular malignant tumours orbital exenteration targeted therapy immunotherapy eye-sparing |
url |
https://www.mdpi.com/2072-6694/13/11/2822 |
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