Spectrum of ocular toxicities from epidermal growth factor receptor inhibitors and their intermediate-term follow-up: A five-year review Journal Article


Authors: Borkar, D. S.; Lacouture, M. E.; Basti, S.
Article Title: Spectrum of ocular toxicities from epidermal growth factor receptor inhibitors and their intermediate-term follow-up: A five-year review
Abstract: Purpose: Epidermal growth factor receptor (EGFR) inhibitors and kinases are commonly used in the treatment regimen of various solid tumors including non-small cell lung, colorectal, head and neck, breast, and pancreatic cancers. The aim of this study is to describe common ocular adverse effects associated with EGFR inhibitor treatment, outline successful management options, and provide data on intermediate-term follow-up of these patients. Methods: A retrospective chart review was performed of all patients presenting to the ophthalmology clinic with an adverse ocular effect while on an EGFR inhibitor. Duration of EGFR inhibitor treatment, symptoms, diagnosis, and treatment information were collected. Statistical analyses were done to ascertain differences in adverse effects based on duration and type of EGFR inhibitor treatment using the Fisher exact test. Results: The two most common EGFR inhibitors in this group of patients were erlotinib and cetuximab. The most common adverse ocular effects for patients on EGFR inhibitors were dysfunctional tear syndrome (DTS), followed by blepharitis and eyelash changes (trichomegaly and trichiasis). Two patients had epithelial defects (corneal abrasions). There was no significant difference in adverse effects based on specific EGFR inhibitor medication or duration of treatment. Almost all patients were successfully managed with treatment regimens that we have outlined in this paper. Intermediate-term follow-up (range 6-17 months) showed a persistence of DTS and eyelash changes. Conclusion: We present what is, to our knowledge, the largest reported cohort of patients with ocular toxicities from EGFR inhibitors - the spectrum of eye toxicities, their management, and the intermediate-term follow-up of patients with eye toxicities. Awareness of this information is important for oncologists and oncology nurses to facilitate proper counseling and management/referral of patients developing eye toxicity while on EGFR inhibitors. © 2012 Springer-Verlag Berlin Heidelberg.
Keywords: controlled study; retrospective studies; major clinical study; erlotinib; drug efficacy; drug safety; drug withdrawal; solid tumor; treatment duration; drug megadose; outcome assessment; follow-up studies; neoplasms; colorectal cancer; lung non small cell cancer; bedtime dosage; receptor, epidermal growth factor; medical record review; cetuximab; panitumumab; antibodies, monoclonal; gefitinib; eye disease; tacrolimus; dry eye; quinazolines; photophobia; eye toxicity; blurred vision; epidermal growth factor receptor kinase inhibitor; medical audit; pimecrolimus; antiinflammatory agent; hygiene; trichiasis; hyperemia; trichomegaly; eye diseases; epiphora; conjunctivitis; cornea disease; ectropion; compression therapy; ocular pruritus; antibodies, monoclonal, humanized; eye drops; eye redness; face rash; ocular toxicities of egfr inhibitors; blepharitis; drug-induced blepharitis; dexamethasone plus neomycin plus polymyxin b; fluorometholone; chalazion; corneal abrasion; dysfunctional tear syndrome; entropion; eye burning; eyelid disease; intraocular foreign body; lid hygiene; chicago
Journal Title: Supportive Care in Cancer
Volume: 21
Issue: 4
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2013-04-01
Start Page: 1167
End Page: 1174
Language: English
DOI: 10.1007/s00520-012-1645-y
PROVIDER: scopus
PUBMED: 23151647
DOI/URL:
Notes: --- - "Export Date: 19 July 2013" - "CODEN: SCCAE" - "Source: Scopus"
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  1. Mario E Lacouture
    457 Lacouture