Ocular toxicities of epidermal growth factor receptor inhibitors and their management

Area of Science:

• Oncology
• Ophthalmology
• Pharmacology

Background:

• Epidermal growth factor receptor (EGFR) inhibitors are vital in treating various solid tumors.
• While generally well-tolerated, EGFR inhibitors can cause adverse effects, notably an acne-like rash.
• Ocular adverse reactions are less common but significantly impact patient comfort, affecting approximately one-third of patients.

Purpose of the Study:

• To describe the spectrum of adverse ocular effects associated with EGFR inhibitor therapy.
• To present management strategies for these ocular toxicities.
• To emphasize the importance of early recognition and intervention.

Main Methods:

• Review of literature on ocular adverse events linked to EGFR inhibitors.
• Categorization of ocular toxicities: eyelid changes (squamous blepharitis, trichomegaly, meibomitis), tear film alterations (dysfunctional tear syndrome), and miscellaneous effects (iridocyclitis, corneal epithelial defects).
• Discussion of management approaches for different severities of ocular reactions.

Main Results:

• Adverse ocular reactions occur in about 33% of patients receiving EGFR inhibitors.
• Common ocular toxicities include eyelid inflammation, altered tear film, and less frequently, iritis or corneal defects.
• Management strategies vary from supportive care by oncology staff for mild cases to specialist ophthalmologist involvement for severe reactions.

Conclusions:

• Adverse ocular reactions are a significant, though often underreported, side effect of EGFR inhibitor therapy.
• Prompt identification and appropriate management of ocular toxicities are essential for patient well-being and treatment continuity.
• A multidisciplinary approach involving oncologists, nurses, and ophthalmologists ensures optimal care for patients experiencing EGFR inhibitor-induced ocular side effects.