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Bilateral keratitis associated with afatinib therapy.
Ya-Tung Liu1, Chen-Wei Lin1, Chi-Chin Sun2,3
1Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Taiwan Journal of Ophthalmology
|April 24, 2024
Summary
Afatinib, an EGFR-TKI, may cause bilateral keratitis. Adjusting the afatinib dose and using eye drops can resolve this ocular side effect.
Area of Science:
- Oncology
- Ophthalmology
- Pharmacology
Background:
- Afatinib is an irreversible epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) used in cancer treatment.
- Nasopharyngeal carcinoma (NPC) is a type of head and neck cancer.
- Ocular side effects are potential complications of EGFR-TKI therapy.
Observation:
- A 52-year-old male patient with stage IV NPC developed bilateral eye dryness and tenderness.
- Symptoms worsened with increased afatinib dosage from 40 mg every other day to 40 mg daily.
- Clinical examination revealed reduced visual acuity, punctate keratopathy, and a corneal epithelial defect.
Findings:
- The patient's condition was diagnosed as bilateral keratitis potentially induced by afatinib.
- Seidel tests were negative, and no signs of infection or other severe ocular complications were observed.
- Reducing afatinib dosage and implementing intensive ocular hydration led to symptom resolution.
Implications:
- This case highlights a potential link between afatinib and bilateral keratitis.
- Early dose adjustment of afatinib and supportive ocular care can effectively manage this side effect.
- Awareness among clinicians is crucial for prompt diagnosis and management of afatinib-induced ocular toxicity.
