Abstract
Purpose: :
To evaluate subconjunctival ranibizumab (Lucentis ®) for squamous carcinoma of the conjunctiva (SCC) and cornea.
Methods: :
Four consecutive patients with biopsy-proven, diffuse multifocal SCC were enrolled in the study after IRB approval and informed consent were obtained. All patients had previous ocular history of excision, cryotherapy, mitomycin chemotherapy, and interferon chemotherapy, with a subsequent biopsy positive for recurrent SCC. Treatment involved subconjunctival injections of ranibizumab (0.5 mg) every 2 to 4 weeks. Ophthalmic examinations included visual acuity (ETDRS chart), slit lamp examination and photography, dilated ophthalmoscopy and high frequency ultrasonography. Blood pressure and systemic monitoring were performed.
Results: :
No adverse ranibizumab-related ocular or systemic side effects have occurred within the first 6 months of therapy. All patients demonstrated improvement or stabilization in tumor size and corneal neovascularization. Visual acuity was noted to improve (n=2) or remain unchanged (n=2) within 6 months of treatment. No SCC growth has been noted during therapy and no patients developed intraocular tumor invasion by high frequency ultrasonography. Unfortunately, there have also been no cases of complete tumor regression.
Conclusions: :
This study suggests that subconjunctival ranibizumab was well tolerated and improved or maintained vision at up to 6 months follow up. Evidence of reduction in tumor size and neovascularization suggests that anti-VEGF therapy may have a role in the treatment of malignant squamous carcinoma of the conjunctiva with corneal extension. Further study of ranibizumab for SCC is warranted.
Clinical Trial: :
www.clinicaltrials.gov NCT00456495
Keywords: tumors • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • conjunctiva