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Ocular abnormalities in patients treated with a novel anti-GD2 monoclonal antibody, hu14.18K322A
Brian C Tse1, Fariba Navid2, Catherine A Billups3
1Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Surgery, Division of Ophthalmology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Purpose:
To determine the incidence of and factors associated with the development of mydriasis and impaired accommodation in patients with refractory or recurrent neuroblastoma receiving the anti-GD2 antibody hu14.18K322A.
Methods:
The medical records of eligible patients with refractory or recurrent neuroblastoma who received escalating doses of hu14.18K322A, ranging from 2 to 70 mg/m(2)/dose for 4 consecutive days every 28 days, were retrospectively reviewed to identify ocular abnormalities arising during the treatment period.
Results:
A total of 38 patients (median age, 7 years; 23 males) were included. All patients underwent comprehensive eye examinations prior to each course of therapy. Mydriasis was seen in 13 patients (34%), and impaired accommodation was seen in 9 (24%), indicating a dose-related effect between hu14.18K322A and both mydriasis (P = 0.021) and impaired accommodation (P = 0.029). Age and sex were not associated with ocular abnormalities. Ocular symptoms resolved in the majority of patients after the drug was discontinued.
Conclusions:
Side effects of mydriasis and impaired accommodation have a dose-dependent relationship with hu14.18K322A. These side effects do not warrant discontinuation of treatment, as they usually resolve after completion of therapy. Management of ocular side effects should focus on treating symptoms with manifest refraction, bifocals, or tinted spectacles.
Insights
The anti-GD2 antibody hu14.18K322A can cause mydriasis and impaired accommodation in neuroblastoma patients. These ocular side effects are dose-dependent but typically resolve after treatment completion.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Pharmacology
Background:
- Neuroblastoma is a challenging pediatric cancer.
- Anti-GD2 antibodies are a promising therapeutic strategy.
- Ocular side effects of novel cancer therapies require careful evaluation.
Purpose of the Study:
- To determine the incidence of mydriasis and impaired accommodation.
- To identify factors associated with these ocular abnormalities.
- To assess the relationship between hu14.18K322A dosage and ocular toxicity.
Main Methods:
- Retrospective review of medical records for neuroblastoma patients treated with hu14.18K322A.
- Analysis of ocular abnormalities during escalating dose therapy (2-70 mg/m(2)/dose).
- Comprehensive eye examinations prior to each treatment course.
Main Results:
- Mydriasis occurred in 34% of patients; impaired accommodation in 24%.
- A significant dose-related effect was observed for both mydriasis (P=0.021) and impaired accommodation (P=0.029).
- Ocular symptoms generally resolved after drug discontinuation; age and sex were not associated factors.
Conclusions:
- Mydriasis and impaired accommodation are dose-dependent side effects of hu14.18K322A.
- These ocular toxicities do not necessitate treatment discontinuation and are usually reversible.
- Symptomatic management with refraction, bifocals, or tinted spectacles is recommended.
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