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Review

New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?

1
Department of Ophthalmology, University Hospital of Nice, Cote d’Azur University, 06000 Nice, France
2
FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Cote d’Azur University, 06000 Nice, France
3
Biobank BB-0033-00025, FHU OncoAge, IRCAN, Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, 06000 Nice, France
4
Department of Dermatology, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France
5
Department of Oncology, Antoine Lacassagne Cancer Centre, 06000 Nice, France
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Department of Biology and Pathologies of Melanocytes, Team1, Equipe Labellisée Ligue 2020 and Equipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, Inserm, 06200 Nice, France
7
Cervicofacial Surgery Department, Antoine Lacassagne Cancer Centre, 06000 Nice, France
*
Author to whom correspondence should be addressed.
Academic Editor: Kavita Y. Sarin
Cancers 2021, 13(11), 2822; https://doi.org/10.3390/cancers13112822
Received: 16 April 2021 / Revised: 24 May 2021 / Accepted: 2 June 2021 / Published: 5 June 2021
(This article belongs to the Special Issue Molecular Mechanisms of Skin Cancer)
Managing locally advanced periocular malignant tumours, especially those invading the orbit, is challenging. Orbital exenteration has long been considered the gold standard. The development of conservative surgical techniques in the early 2000s, followed by the emergence of new targeted therapies and immunotherapies over the past decade, has led to a paradigm shift towards the use of ‘eye-sparing’ strategies.
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. View Full-Text
Keywords: periocular malignant tumours; orbital exenteration; targeted therapy; immunotherapy; eye-sparing periocular malignant tumours; orbital exenteration; targeted therapy; immunotherapy; eye-sparing
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MDPI and ACS Style

Martel, A.; Lassalle, S.; Picard-Gauci, A.; Gastaud, L.; Montaudie, H.; Bertolotto, C.; Nahon-Esteve, S.; Poissonnet, G.; Hofman, P.; Baillif, S. New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? Cancers 2021, 13, 2822. https://doi.org/10.3390/cancers13112822

AMA Style

Martel A, Lassalle S, Picard-Gauci A, Gastaud L, Montaudie H, Bertolotto C, Nahon-Esteve S, Poissonnet G, Hofman P, Baillif S. New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm? Cancers. 2021; 13(11):2822. https://doi.org/10.3390/cancers13112822

Chicago/Turabian Style

Martel, Arnaud, Sandra Lassalle, Alexandra Picard-Gauci, Lauris Gastaud, Henri Montaudie, Corine Bertolotto, Sacha Nahon-Esteve, Gilles Poissonnet, Paul Hofman, and Stephanie Baillif. 2021. "New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?" Cancers 13, no. 11: 2822. https://doi.org/10.3390/cancers13112822

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