Ocular surface adverse events of systemic epidermal growth factor receptor inhibitors (EGFRi): A prospective trial

Area of Science:

• Ophthalmology
• Oncology
• Pharmacology

Background:

• Systemic epidermal growth factor receptor inhibitors (EGFRi) are used in cancer treatment.
• The ocular surface toxicity of EGFRi is a subject of ongoing debate.
• This study investigates the impact of EGFRi on ocular surface health.

Purpose of the Study:

• To compare the ocular surface toxicity of systemic EGFRi between cancer patients receiving treatment and a control group.
• To evaluate the effects of EGFRi on dry eye signs and symptoms.
• To assess changes in corneal epithelial cell density (CEBD) and corneal subepithelial nerve fiber density (CNFD) in patients treated with EGFRi.

Main Methods:

• A prospective clinical study involving 50 chemotherapy-naive patients (25 EGFRi-treated, 25 controls) with lung or colon cancer.
• Ocular assessments included symptom questionnaires (SIDEQ, OSDI, AVS), corneal staining (Oxford test), tear production (Schirmer's test), and evaluation of conjunctival chemosis and hyperemia.
• Confocal microscopy was used to measure basal epithelial cell density (CEBD) and corneal subepithelial nerve fiber density (CNFD).

Main Results:

• No statistically significant differences in ocular variables were found between the EGFRi and control groups.
• However, the EGFRi group showed a significantly worse progression of ocular signs, including chemosis, corneal staining, and reduced tear production.
• The EGFRi group also exhibited a significant decrease in CEBD and CNFD compared to controls.

Conclusions:

• Systemic EGFRi treatment may be associated with an increase in dry eye signs.
• EGFRi may lead to a reduction in corneal epithelial cell density and subepithelial nerve fiber density.
• This study contributes to understanding the ocular surface toxicity profile of systemic EGFRi in cancer patients.