Ocular adverse events associated with antibody-drug conjugates used in cancer: Focus on pathophysiology and management strategies

IF 18.6 1区 医学 Q1 OPHTHALMOLOGY
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Abstract

Antibody-drug conjugates (ADCs) are designed to maximize cancer cell death with lower cytotoxicity toward noncancerous cells and are an increasingly valuable option for targeted cancer therapies. However, anticancer treatment with ADCs may be associated with ocular adverse events (AEs) such as dry eye, conjunctivitis, photophobia, blurred vision, and corneal abnormalities. While the pathophysiology of ADC-related ocular AEs has not been fully elucidated, most ocular AEs are attributed to off-target effects. Product labelling for approved ADCs includes drug-specific guidance for dose modification and management of ocular AEs; however, limited data are available regarding effective strategies to minimize and mitigate ocular AEs. Overall, the majority of ocular AEs are reversible through dose modification or supportive care. Eye care providers play key roles in monitoring patients receiving ADC therapy for ocular signs and symptoms to allow for the early detection of ADC-related ocular AEs and to ensure the timely administration of appropriate treatment. Therefore, awareness is needed to help ophthalmologists to identify treatment-related ocular AEs and provide effective management in collaboration with oncologists as part of the patient's cancer care team. This review provides an overview of ocular AEs that may occur with approved and investigational ADC anticancer treatments, including potential underlying mechanisms for ADC-related ocular AEs. It also discusses clinical management practices relevant to ophthalmologists for prevention, monitoring, and management of ADC-related ocular AEs. In collaboration with oncologists, ophthalmologists play a vital role in caring for patients with cancer by assisting with the prompt recognition, mitigation, and management of treatment-related ocular AEs.
与癌症中使用的抗体药物共轭物相关的眼部不良反应:病理生理学和管理策略。
抗体-药物共轭物(ADCs)旨在最大程度地杀死癌细胞,同时降低对非癌细胞的细胞毒性,是一种越来越有价值的癌症靶向疗法。然而,使用 ADCs 进行抗癌治疗可能会引起眼部不良反应(AEs),如干眼症、结膜炎、畏光、视力模糊和角膜异常。虽然 ADC 相关眼部不良反应的病理生理学尚未完全阐明,但大多数眼部不良反应可归因于脱靶效应。已获批准的 ADC 的产品标签包括剂量调整和眼部 AE 管理的特定药物指导;然而,有关最大限度减少和缓解眼部 AE 的有效策略的数据有限。总体而言,通过剂量调整或支持性护理,大多数眼部 AE 是可逆的。眼科护理人员在监测接受 ADC 治疗的患者的眼部体征和症状方面发挥着关键作用,以便及早发现 ADC 相关的眼部 AE,并确保及时给予适当的治疗。因此,我们需要提高认识,帮助眼科医生识别与治疗相关的眼部 AE,并与作为患者癌症护理团队一部分的肿瘤科医生合作提供有效的管理。本综述概述了已批准和正在研究的 ADC 抗癌治疗可能出现的眼部 AE,包括 ADC 相关眼部 AE 的潜在潜在机制。它还讨论了眼科医生在预防、监测和管理 ADC 相关眼部 AE 方面的临床管理实践。眼科医生与肿瘤科医生合作,通过协助及时识别、缓解和管理与治疗相关的眼部 AE,在护理癌症患者方面发挥着重要作用。
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来源期刊
CiteScore
34.10
自引率
5.10%
发文量
78
期刊介绍: Progress in Retinal and Eye Research is a Reviews-only journal. By invitation, leading experts write on basic and clinical aspects of the eye in a style appealing to molecular biologists, neuroscientists and physiologists, as well as to vision researchers and ophthalmologists. The journal covers all aspects of eye research, including topics pertaining to the retina and pigment epithelial layer, cornea, tears, lacrimal glands, aqueous humour, iris, ciliary body, trabeculum, lens, vitreous humour and diseases such as dry-eye, inflammation, keratoconus, corneal dystrophy, glaucoma and cataract.
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