Ocular Toxicity Profile of Targeted Cancer Therapy (TCT) at a US Tertiary Cancer Center

Moe Ameri; Nagham Al Zubidi; Azadeh Razmandi; Andrew Whyte; Aung Naing; Nimisha A Patel; Dan S Gombos

doi:10.7759/cureus.40597

Ocular Toxicity Profile of Targeted Cancer Therapy (TCT) at a US Tertiary Cancer Center

Cureus. 2023 Jun 18;15(6):e40597. doi: 10.7759/cureus.40597. eCollection 2023 Jun.

Authors

Moe Ameri¹, Nagham Al Zubidi², Azadeh Razmandi³, Andrew Whyte⁴, Aung Naing⁵, Nimisha A Patel⁴, Dan S Gombos⁴

Affiliations

¹ Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
² Investigational Cancer Therapeutics / Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, USA.
³ Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, USA.
⁴ Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, USA.
⁵ Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, USA.

Abstract

Purpose: Targeted cancer therapy (TCT) is a significant advancement in oncology with promising survival improvement in patients with cancer and remarkable effects on various cancers. There is evidence suggesting a connection between specific TCT classes and the occurrence of immune-related adverse events (irAEs). Our study aims to investigate the potential ocular toxicities of different classes of TCT, provide a better understanding of these toxicities, and aid in the future development of screening and management recommendations for ocular irAEs.

Design: Retrospective observational case series.

Participants: Only ocular immune-related AEs were included in the study; patients on TCT who received a new ophthalmic diagnosis were seen at the MD Anderson Cancer Center.

Methods: Between 2010 and 2019, we retrospectively reviewed the medical records of 6,354 patients on TCT at a large US tertiary cancer center. Results: The criteria for data analysis were met by 1861 patients. TCT was associated with a wide range of class-specific ocular irAEs. There was a statistically significant correlation between ocular toxicity with polytherapy with a p-value of <0.001. Furthermore, there was a statistically significant correlation between toxicity and BRAF, epidermal growth factor receptor (EGFR), and ICI <0.001, <0.001, and 0.006, respectively. Conclusion: Our cohort is the most extensive case series in English literature, demonstrating the increased risk of class-specific ocular toxicity associated with TCT, which sheds some light on the importance of developing standardized grading criteria and management guidelines.

Keywords: immune-related adverse events (iraes); immunotherapies; ocular iraes; ocular toxicity; targeted cancer therapy.