{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:30:32Z","timestamp":1790688632335,"version":"4.1.0"},"reference-count":51,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The management of periocular skin malignant tumours is challenging. Surgery remains the mainstay of treatment for localised eyelid cancers. For more locally advanced cancers, especially those invading the orbit, orbital exenteration has long been considered the gold standard; however, it is a highly disfiguring and traumatic surgery. The last two decades have been marked by the emergence of a new paradigm shift towards the use of \u2018eye-sparing\u2019 strategies. In the early 2000s, the first step consisted of performing wide conservative eyelid and orbital excisions. Multiple flaps and grafts were needed, as well as adjuvant radiotherapy in selected cases. Although being incredibly attractive, several limitations such as the inability to treat the more posteriorly located orbital lesions, as well as unbearable diplopia, eye pain and even secondary eye loss were identified. Therefore, surgeons should distinguish \u2018eye-sparing\u2019 from \u2018sight-sparing\u2019 strategies. The second step emerged over the last decade and was based on the development of targeted therapies and immunotherapies. Their advantages include their potential ability to treat almost all tumours, regardless of their locations, without performing complex surgeries. However, several limitations have been reported, including their side effects, the appearance of primary or secondary resistances, their price and the lack of consensus on treatment regimen and exact duration. The aim of this article was to review the evolution of the management of locally advanced periocular malignant tumours over the last three decades and highlight the new paradigm shift towards the use of \u2018eye-sparing\u2019 strategies.<\/jats:p>","DOI":"10.3390\/cancers13112822","type":"journal-article","created":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T23:59:55Z","timestamp":1623023995000},"page":"2822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New \u2018Eye-Sparing\u2019 Paradigm?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3836-7126","authenticated-orcid":false,"given":"Arnaud","family":"Martel","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Nice, Cote d\u2019Azur University, 06000 Nice, France"},{"name":"FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Cote d\u2019Azur University, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Lassalle","sequence":"additional","affiliation":[{"name":"FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Cote d\u2019Azur University, 06000 Nice, France"},{"name":"Biobank BB-0033-00025, FHU OncoAge, IRCAN, Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Picard-Gauci","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauris","family":"Gastaud","sequence":"additional","affiliation":[{"name":"Department of Oncology, Antoine Lacassagne Cancer Centre, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Montaudie","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine","family":"Bertolotto","sequence":"additional","affiliation":[{"name":"Department of Biology and Pathologies of Melanocytes, Team1, Equipe Labellis\u00e9e Ligue 2020 and Equipe Labellis\u00e9e ARC 2019, Centre M\u00e9diterran\u00e9en de M\u00e9decine Mol\u00e9culaire, Inserm, 06200 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2274-0256","authenticated-orcid":false,"given":"Sacha","family":"Nahon-Esteve","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Nice, Cote d\u2019Azur University, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Poissonnet","sequence":"additional","affiliation":[{"name":"Cervicofacial Surgery Department, Antoine Lacassagne Cancer Centre, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-9353","authenticated-orcid":false,"given":"Paul","family":"Hofman","sequence":"additional","affiliation":[{"name":"FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Cote d\u2019Azur University, 06000 Nice, France"},{"name":"Biobank BB-0033-00025, FHU OncoAge, IRCAN, Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1700-8570","authenticated-orcid":false,"given":"Stephanie","family":"Baillif","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Nice, Cote d\u2019Azur University, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.3341\/kjo.2018.0052","article-title":"Orbital exenteration: A 23-year report","volume":"33","author":"Kasaee","year":"2019","journal-title":"Korean J. 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