Ocular toxicities associated with targeted anticancer agents: an analysis of clinical data with management suggestions
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Chen Fu1, Dan S. Gombos5, Jared Lee2, Goldy C. George3, Kenneth Hess4, Andrew Whyte5 and David S. Hong3
1Department of Internal Medicine, New York University Langone Medical Center, NY 10016, USA
2Department of Internal Medicine, Baylor College of Medicine, TX 77030, USA
3Department of Phase I Clinical Trials, The University of Texas MD Anderson Cancer Center, TX 77030, USA
4Department of Biostatistics, The University of Texas MD Anderson Cancer Center, TX 77030, USA
5Department of Head and Neck Surgery, Division of Ophthalmology, The University of Texas MD Anderson Cancer Center, TX 77030, USA
David S. Hong, email: email@example.com
Keywords: targeted, cancer, ocular, toxicity, management
Received: September 20, 2016 Accepted: March 16, 2017 Published: May 05, 2017
Ocular toxicities are among the most common adverse events resulting from targeted anticancer agents and are becoming increasingly relevant in the management of patients on these agents. The purpose of this study is to provide a framework for management of these challenging toxicities based on objective data from FDA labels and from analysis of the literature. All oncologic drugs approved by the FDA up to March 14, 2015, were screened for inclusion. A total of 16 drugs (12 small-molecule drugs and 4 monoclonal antibodies) were analyzed for ocular toxicity profiles based on evidence of ocular toxicity. Trials cited by FDA labels were retrieved, and a combination search in Medline, Google Scholar, the Cochrane database, and the NIH Clinical Trials Database was conducted. The majority of ocular toxicities reported were low severity, and the most common were conjunctivitis and “visual disturbances.” However, severe events including incidents of blindness, retinal vascular occlusion, and corneal ulceration occurred. The frequency and severity at which ocular toxicities occur merits a more multidisciplinary approach to managing patients with agents that are known to cause ocular issues. We suggest a standardized methodology for referral and surveillance of patients who are potentially at risk of severe ocular toxicity.
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