Universität zu Köln

Rokohl, Alexander C., Koch, Konrad R., Morl, Joel M., Loreck, Niklas, Schlaak, Max, Mauch, Cornelia, Bechrakis, Nikolaos E., Mohi, Armin, Kakkassery, Vinodh and Heindl, Ludwig M. (2020). Personalized medicine in the treatment of periocular tumors Targeted treatment and use of immune checkpoint inhibitors. Ophthalmologe, 117 (6). S. 521 - 528. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

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Abstract

The aim of this article is to provide an overview on the current state of personalized medicine in the systemic treatment of selected periocular tumors, such as basal cell carcinoma, Merkel cell carcinoma and conjunctival melanoma. This article therefore provides an extensive current literature review from PubMed including the current guidelines and standard operating procedures (SOP). As 90% of basal cell carcinomas have a pathologic activation of the sonic hedgehog pathway, vismodegib is a new treatment option for inoperable or metastatic basal cell carcinoma and for patients with Gorlin-Goltz syndrome. A novel approach of systemic medicine for the treatment of metastatic Merkel cell carcinoma is immunotherapy using the immune checkpoint inhibitor avelumab. Other personalized immunotherapies, such as the checkpoint inhibitors pembrolizumab and nivolumab, the tyrosine kinase inhibitor pazopanib and the role of the hedgehog pathway in Merkel cell carcinomas are the subject of current research and will certainly play an important role in future treatment. In the narrow sense personalized medicine has only come true for metastatic conjunctival melanomas: systemic treatment with BRAF, MEK and/or checkpoint inhibitors is initiated only when a BRAF mutation is detected in the tumor or metastatic tissue. Systemic immunotherapy with the checkpoint inhibitors pembrolizumab and nivolumab can also be used as a treatment option in metastatic conjunctival melanomas. In summary, personalized medicine is a subject of current research and provides many new targeted treatment options especially for periocular malignancies; however, it also involves many great challenges in the development and implementation of new techniques and therapies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rokohl, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Konrad R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Morl, Joel M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loreck, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlaak, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauch, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Bechrakis, Nikolaos E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohi, Armin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kakkassery, Vinodh UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-331767
DOI:	10.1007/s00347-019-01034-z
Journal or Publication Title:	Ophthalmologe
Volume:	117
Number:	6
Page Range:	S. 521 - 528
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0423
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MERKEL CELL-CARCINOMA; ADJUVANT THERAPY; LYMPHANGIOGENESIS; MELANOMAS; DIAGNOSIS; AVELUMAB; SKIN Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33176