Neurotrophic Keratitis Associated With Telisotuzumab Vedotin: A Case Report

Area of Science:

• Ophthalmology
• Oncology
• Pharmacology

Background:

• Telisotuzumab vedotin (Teliso-V) is an antibody-drug conjugate (ADC) targeting c-MET, approved for metastatic non-small cell lung cancer (NSCLC).
• Ocular toxicity is a known concern with some ADCs, but specific associations require detailed reporting.

Purpose of the Study:

• To report the first case of neurotrophic keratitis (NK) potentially associated with telisotuzumab vedotin (Teliso-V) therapy.
• To highlight the clinical presentation, management, and outcome of this adverse event.

Main Methods:

• A case report of a 56-year-old woman with metastatic NSCLC treated with Teliso-V.
• Detailed description of ocular findings, including corneal epithelial defects and reduced corneal sensation.
• Documentation of concurrent peripheral neuropathy and response to treatment with cenegermin.

Main Results:

• The patient developed bilateral blurred vision, punctate keratopathy, and persistent corneal epithelial defects 10 weeks after starting Teliso-V.
• Corneal esthesiometry confirmed reduced sensation, indicative of NK, alongside Grade 1 peripheral neuropathy.
• Treatment with topical cenegermin led to resolution of epithelial defects and visual recovery within weeks.

Conclusions:

• This case suggests a potential neurotoxic mechanism of Teliso-V, possibly linked to its monomethyl auristatin E payload, causing NK.
• Clinicians should consider NK in patients on ADCs presenting with visual decline and corneal abnormalities.
• Prompt diagnosis and treatment with cenegermin are crucial for managing Teliso-V-associated NK and preventing vision loss.