Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI.
University of Michigan, Ann Arbor, MI; and.
Cornea. 2024 Apr 1;43(4):528-530. doi: 10.1097/ICO.0000000000003452. Epub 2024 Jan 2.
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.
A report of 2 cases with CIN who were treated with systemic cemiplimab (350 mg IV every 3 weeks).
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.
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.
免疫检查点抑制剂 (ICI) 最近已被引入用于治疗局部不可切除的结膜鳞状细胞癌。我们报告了 2 例接受 ICI 治疗的结膜上皮内瘤变 (CIN) 患者。
报告了 2 例接受系统西普利单抗 (350 mg IV，每 3 周 1 次) 治疗的 CIN 患者。
一名 70 岁男性因转移性皮肤鳞状细胞癌接受西普利单抗治疗。鼻球结膜和角膜的原有 CIN 持续进展，而其他转移性部位，包括腮腺和颈部淋巴结，在治疗 16 个周期后完全缓解。一名 84 岁女性患有双侧弥漫性 CIN，累及球结膜和下眼睑睑结膜。由于病变范围广泛，开始使用西普利单抗。尽管大部分 CIN 减少，但在 10 个周期的治疗后，OC 的角膜和穹窿结膜仍有进展。西普利单抗治疗后对结膜病变进行的活检证实了这 2 例患者的 CIN。
尽管结膜鳞状细胞癌肿瘤对 ICI 高度敏感，但在 2 例 CIN 患者中未观察到类似的效果。需要进一步的研究来评估 ICI 在 CIN 管理中的作用。
