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Ocular Toxicity Profile of Targeted Cancer Therapy (TCT) at a US Tertiary Cancer Center
Moe Ameri1, Nagham Al Zubidi2, Azadeh Razmandi3
1Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
Purpose:
Targeted cancer therapy (TCT) is a significant advancement in oncology with promising survival improvement in patients with cancer and remarkable effects on various cancers. There is evidence suggesting a connection between specific TCT classes and the occurrence of immune-related adverse events (irAEs). Our study aims to investigate the potential ocular toxicities of different classes of TCT, provide a better understanding of these toxicities, and aid in the future development of screening and management recommendations for ocular irAEs.
Design:
Retrospective observational case series.
Participants:
Only ocular immune-related AEs were included in the study; patients on TCT who received a new ophthalmic diagnosis were seen at the MD Anderson Cancer Center.
Methods:
Between 2010 and 2019, we retrospectively reviewed the medical records of 6,354 patients on TCT at a large US tertiary cancer center. Results: The criteria for data analysis were met by 1861 patients. TCT was associated with a wide range of class-specific ocular irAEs. There was a statistically significant correlation between ocular toxicity with polytherapy with a p-value of <0.001. Furthermore, there was a statistically significant correlation between toxicity and BRAF, epidermal growth factor receptor (EGFR), and ICI <0.001, <0.001, and 0.006, respectively. Conclusion: Our cohort is the most extensive case series in English literature, demonstrating the increased risk of class-specific ocular toxicity associated with TCT, which sheds some light on the importance of developing standardized grading criteria and management guidelines.
Insights
Targeted cancer therapies (TCT) can cause ocular immune-related adverse events (irAEs). This study found specific TCT classes correlate with increased eye toxicity, highlighting the need for screening and management guidelines.
Area of Science:
- Oncology
- Ophthalmology
- Immunology
Background:
- Targeted cancer therapy (TCT) offers improved survival for cancer patients.
- Immune-related adverse events (irAEs) are known side effects of TCT.
- Ocular toxicities associated with TCT require further investigation.
Purpose of the Study:
- To investigate ocular toxicities linked to different classes of TCT.
- To enhance understanding of TCT-induced ocular toxicities.
- To inform future recommendations for screening and managing ocular irAEs.
Main Methods:
- Retrospective observational case series.
- Reviewed medical records of 6,354 patients on TCT from 2010-2019.
- Included 1,861 patients with ocular immune-related adverse events.
Main Results:
- TCT is associated with various class-specific ocular irAEs.
- Polytherapy showed a significant correlation with ocular toxicity (p<0.001).
- BRAF, EGFR, and immune checkpoint inhibitors (ICI) also showed significant correlations with toxicity (p<0.001, p<0.001, and p=0.006, respectively).
Conclusions:
- This extensive case series demonstrates increased class-specific ocular toxicity risk with TCT.
- Findings emphasize the importance of standardized grading criteria for ocular irAEs.
- Development of management guidelines for TCT-related ocular toxicities is crucial.
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