Ocular and Periocular Squamous Cell Carcinoma

The addition of immune checkpoint inhibitors (ICIs), especially PD-1 inhibitors, as a treatment option for patients with locally advanced or metastatic periocular squamous cell carcinoma (SCC) with orbital invasion or perineural spread (PNS) is a major advance. In the case of patients with locally advanced periocular SCC with orbital invasion, ICIs can result in significant tumor shrinkage and potential avoidance of orbital exenteration or other radical surgery. In the case of SCC with PNS, using PD-1 inhibitors, as an alternative to high-dose orbital radiation therapy, is effective and can prevent vision loss and ocular toxicity from radiation. For conjunctival SCC, PD-1 inhibitors can result in tumor shrinkage in patients with high tumor mutation burden.