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联合使用新辅助帕博利珠单抗和 Mohs 手术治疗双侧眶周微卫星不稳定型皮脂癌。

Combination treatment of bilateral periocular sebaceous carcinomas with microsatellite instability with neoadjuvant pembrolizumab and Mohs surgery.

机构信息

Department of Dermatology, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA.

Department of Dermatology, Cook County Health, Chicago, Illinois, USA.

出版信息

Australas J Dermatol. 2022 Nov;63(4):e345-e349. doi: 10.1111/ajd.13919. Epub 2022 Sep 8.

DOI:10.1111/ajd.13919
PMID:36073830
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9825858/
Abstract

This case highlights the successful use of pembrolizumab for neoadjuvant treatment of MMR-deficient sebaceous carcinoma of bilateral eyelids to reduce tumour burden allowing smaller defect post-Mohs surgery and better reconstructive outcome. Microsatellite stability, tumour mutational burden and PD-L1 expression are important prognostic factors to be considered for the use of neoadjuvant pembrolizumab. Further studies are needed to determine if neoadjuvant pembrolizumab consistently improves surgical and cosmetic outcomes and reduces local recurrence and metastasis.

摘要

本病例强调了帕博利珠单抗在双侧眼睑 MMR 缺陷性皮脂腺癌新辅助治疗中的成功应用，其降低了肿瘤负荷，使得 Mohs 手术后缺损更小，重建效果更好。微卫星稳定性、肿瘤突变负担和 PD-L1 表达是考虑使用新辅助帕博利珠单抗的重要预后因素。需要进一步的研究来确定新辅助帕博利珠单抗是否能持续改善手术和美容效果，降低局部复发和转移的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/759241b34d1a/AJD-63-e345-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/91a9826b6b83/AJD-63-e345-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/c97e4335165d/AJD-63-e345-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/759241b34d1a/AJD-63-e345-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/91a9826b6b83/AJD-63-e345-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/c97e4335165d/AJD-63-e345-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2216/9825858/759241b34d1a/AJD-63-e345-g003.jpg

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JCO Precis Oncol. 2020 Nov;4:61-65. doi: 10.1200/PO.19.00302.
2
Sebaceous Carcinoma of the Eyelid: A Systematic Review and Meta-Analysis.眼睑皮脂癌：系统评价和荟萃分析。
Dermatol Surg. 2021 Jan 1;47(1):104-110. doi: 10.1097/DSS.0000000000002660.
3
The DNA mismatch repair system in sebaceous tumors: an update on the genetics and workup of Muir-Torre syndrome.
眼周皮肤恶性肿瘤治疗的最新进展综述
Front Oncol. 2024 Mar 4;14:1275930. doi: 10.3389/fonc.2024.1275930. eCollection 2024.
皮脂腺肿瘤中的DNA错配修复系统：穆尔-托雷综合征遗传学及检查方法的最新进展
Cutis. 2020 Mar;105(3):E34-E37.
4
Sebaceous carcinoma: controversies and their evidence for clinical practice.皮脂腺癌：争议及其对临床实践的证据。
Arch Dermatol Res. 2020 Jan;312(1):25-31. doi: 10.1007/s00403-019-01971-4. Epub 2019 Aug 30.
5
Mismatch repair deficiency/microsatellite instability-high as a predictor for anti-PD-1/PD-L1 immunotherapy efficacy.错配修复缺陷/微卫星不稳定高作为抗 PD-1/PD-L1 免疫治疗疗效的预测指标。
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