Ocular adverse events of molecularly targeted agents approved in solid tumours: A systematic review

abstract

When using molecularly targeted agents (MTAs), oncologists and patients face new and sometimes unexpected toxicities. Though ocular adverse events (OAEs) are not uncommon with chemotherapy, they are rarely severe or dose limiting. Ocular toxicity profile may differ with MTAs, indeed severe and dose limiting toxicities have been described with targeted therapies currently under investigation. Our study aimed to review OAEs experienced with MTAs approved in solid tumours. This review revealed that many OAEs, frequent and potentially severe, exist and concern most MTAs. The suggestion is prompt referral of patients with severe pain and/or visual impairment to the ophthalmologist since these symptoms can be associated with potentially severe OAE and need ophthalmic assessment. Oncologists must be aware of such events and their potential severity for better treatment and better diagnosis in daily practice as well as in clinical trials. 

Table 1.(requires subscription to view/+other tables)
Characteristics of molecularly targeted agents reviewed and description of analysed reports.

FDA, U.S. Food and Drug Administration; EMA, European Medicines Agency; Mab, Monoclonal antibody; TKI, Tyrosine Kinase Inhibitor; SR, Soluble Receptor; STKI, Serine-Threonine Kinase Inhibitor; EGFR, Epidermal Growth Factor Receptor; HER2, Human Epidermal Growth Factor Receptor 2; VEGF, Vascular Endothelial Growth Factor; VEGFR, Vascular Endothelial Growth Factor Receptor; PDGFR, Platelet-Derived Growth factor Receptor; FGFR, Fibroblast Growth factor Receptor; Kit, Stem cell factor receptor (or C-Kit or CD117); FLT-3, Fms-like tyrosine kinase-3; CSF-1R, Colony Stimulating Factor Receptor Type 1; RET, glial cell-line derived neurotrophic factor receptor; cMet, Hepatocyte Growth Factor Receptor; mTOR, mammalian Target Of Rapamycin; ALK, Anaplastic Lymphoma Kinase; CTLA-4, Cytotoxic T-Lymphocyte-Associated Antigen 4; MEK, Mitogen-activated Extracellular signal regulated Kinase; BP, Binding Protein; SMO, Smoothened transmembrane protein of the Hedgehog pathway.