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Incidence and Mitigation of Corneal Pseudomicrocysts Induced by Antibody–Drug Conjugates (ADCs)

Authors
  • Lindgren, Ethan S
  • Yan, Rongshan
  • Cil, Onur
  • Verkman, Alan S
  • Chan, Matilda F
  • Seitzman, Gerami D
  • Farooq, Asim V
  • Huppert, Laura A
  • Rugo, Hope S
  • Pohlmann, Paula R
  • Lu, Janice
  • Esserman, Laura J
  • Pasricha, Neel D
Publication Date
Jun 01, 2024
Source
eScholarship - University of California
Keywords
License
Unknown
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Abstract

Purpose of reviewThis study is to highlight the incidence of corneal pseudomicrocysts in FDA-approved antibody-drug conjugates (ADCs), and success of preventive therapies for pseudomicrocysts and related ocular surface adverse events (AEs).Recent findingsADCs are an emerging class of selective cancer therapies that consist of a potent cytotoxin connected to a monoclonal antibody (mAb) that targets antigens expressed on malignant cells. Currently, there are 11 FDA-approved ADCs with over 164 in clinical trials. Various AEs have been attributed to ADCs, including ocular surface AEs (keratitis/keratopathy, dry eye, conjunctivitis, blurred vision, corneal pseudomicrocysts). While the severity and prevalence of ADC-induced ocular surface AEs are well reported, the reporting of corneal pseudomicrocysts is limited, complicating the development of therapies to prevent or treat ADC-related ocular surface toxicity.SummaryThree of 11 FDA-approved ADCs have been implicated with corneal pseudomicrocysts, with incidence ranging from 41 to 100% of patients. Of the six ADCs that reported ocular surface AEs, only three had ocular substudies to investigate the benefit of preventive therapies including topical steroids, vasoconstrictors, and preservative-free lubricants. Current preventive therapies demonstrate limited efficacy at mitigating pseudomicrocysts and other ocular surface AEs.

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