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Ophthalmologic toxicities of antineoplastic agents in genitourinary cancers: Mechanisms, management, and clinical
Aditya Mahadevan1, Omid Yazdanpanah2, Vivek Patel3
1Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Abstract:
Genitourinary cancers affect over 480,000 patients in the United States annually. While promising therapeutic modalities continue to emerge, notably immune checkpoint inhibitors, molecular targeted therapies, antibody-drug conjugates, and radioligand therapies, these treatments are associated with a spectrum of adverse side-effects, including ophthalmologic toxicities. In this review, we cover the most commonly used antineoplastic agents for the kidneys, bladder, urinary tracts, prostate, testis, and penis, detailing mechanism, indication, and recent trials supporting their use. For each category of antineoplastic therapy, we describe the epidemiology, management, and clinical presentation, of common ophthalmologic toxicities stemming from these agents. This review serves to augment awareness and recognition of possible ophthalmologic manifestations resulting from the use of antineoplastic agents in genitourinary malignancy. Early identification of these side effects can hasten ophthalmology referral and ultimately improve visual outcomes in patients experiencing medication-induced ocular toxicities.
Insights
New cancer treatments for genitourinary cancers can cause eye problems. This review details common eye toxicities from these therapies, aiding early detection and better visual outcomes for patients.
Area of Science:
- Oncology
- Ophthalmology
- Pharmacology
Background:
- Genitourinary cancers impact over 480,000 US patients annually.
- Emerging therapies include immune checkpoint inhibitors, targeted therapies, antibody-drug conjugates, and radioligand therapies.
- These advanced treatments can cause significant ophthalmologic toxicities.
Purpose of the Study:
- To review antineoplastic agents used for genitourinary cancers.
- To detail the mechanism, indications, and trials for these agents.
- To describe the epidemiology, presentation, and management of associated ocular toxicities.
Main Methods:
- Comprehensive literature review of antineoplastic agents for genitourinary cancers.
- Focused analysis on common ophthalmologic side effects.
- Synthesis of information on disease mechanisms, clinical presentation, and management strategies.
Main Results:
- Commonly used antineoplastic agents for kidney, bladder, prostate, and other genitourinary cancers are identified.
- Specific ophthalmologic toxicities associated with each therapy class are detailed.
- Epidemiology, clinical manifestations, and management guidelines for ocular toxicities are presented.
Conclusions:
- Awareness and recognition of medication-induced ocular toxicities are crucial.
- Early identification facilitates timely ophthalmology referral.
- Prompt management can improve visual outcomes in patients with genitourinary cancers.
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