Adverse effects of anti-cancer biologics on the ocular surface

Area of Science:

• Ophthalmology
• Oncology
• Immunology

Background:

• Cancer immunotherapy, particularly immune checkpoint inhibitors (ICIs) and epidermal growth factor receptor (EGFR) inhibitors, is a rapidly advancing field.
• Ocular side effects are prevalent, affecting up to 70% of patients undergoing these treatments.
• Corneal involvement can range from mild irritation to severe ulceration and vision loss.

Purpose of the Study:

• To review the incidence of ocular surface side effects in cancer patients receiving immunotherapy.
• To elucidate the mechanisms behind these immunotherapy-induced ocular complications.
• To outline the management strategies for ocular surface and corneal adverse events.

Main Methods:

• Literature review of studies on cancer immunotherapy and ocular side effects.
• Analysis of pathogenic mechanisms triggered by various immunotherapeutic agents.
• Synthesis of current management guidelines for ophthalmologists and oncologists.

Main Results:

• Immune checkpoint inhibitors (ICIs) and EGFR inhibitors are frequently associated with ocular surface and corneal complications.
• These conditions pose a risk of sight-threatening complications requiring vigilant monitoring.
• Corneal involvement manifests through diverse pathogenic pathways.

Conclusions:

• Immunotherapy-related corneal complications significantly decrease patients' quality of life.
• Early recognition and diagnosis of ocular adverse events are crucial.
• An interdisciplinary approach involving ophthalmologists and oncologists is essential for effective management and preserving ocular integrity.