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

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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.

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Acknowledgments

Dr. Basti is supported by the IDP Foundation and the Robert H. Lurie Comprehensive Cancer Center at Northwestern University. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the IDP Foundation and the Robert H. Lurie Comprehensive Cancer Center. The Department of Ophthalmology, Northwestern University Feinberg School of Medicine, is supported by an unrestricted grant from Research to Prevent Blindness, NY.

Conflicts of interest

None of the authors have any conflicts of interest to report.

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Authors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Durga S. Borkar

  2. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA

    Mario E. Lacouture & Surendra Basti

  3. Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Mario E. Lacouture

  4. Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave, Suite #440, Chicago, IL, 60611, USA

    Surendra Basti

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  1. Durga S. Borkar
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  2. Mario E. Lacouture
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Correspondence to Surendra Basti.

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Borkar, D.S., Lacouture, M.E. & Basti, S. Spectrum of ocular toxicities from epidermal growth factor receptor inhibitors and their intermediate-term follow-up: a five-year review. Support Care Cancer 21, 1167–1174 (2013). https://doi.org/10.1007/s00520-012-1645-y

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  • DOI: https://doi.org/10.1007/s00520-012-1645-y

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