Corneal Changes in Trastuzumab Emtansine Treatment

Kreps, Elke O.; Derveaux, Thierry; Denys, Hannelore

doi:10.1016/j.clbc.2018.03.005

Cited by 28 publications

(30 citation statements)

References 20 publications

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“…In a very recent study by Chiang et al [ 5 ], in vivo CLSM revealed a significant reduction in corneal nerve fibers in patients with paclitaxel-induced neuropathy. Moreover, corneal changes detected by in vivo CLSM were also found in breast cancer patients treated with trastuzumab [ 6 , 7 , 8 ].…”

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confidence: 99%

“…In vivo CLSM generates surface-parallel images of the native cornea with cellular resolution, and it can be used to image dendritic cells (DCs) as well as nerves from the subbasal nerve plexus (SNP) with high contrast [ 10 ]. Moreover, several studies have shown that SNP changes are not characteristic of one specific corneal pathology but rather reflect non-specific pathological processes that are present in many corneal, ocular, or systemic diseases [ 11 , 12 , 13 ] or arise as a result of a therapy regime, such as that used to treat multiple myeloma [ 14 ] or breast cancer [ 6 , 7 , 8 ]. Thus, time-lapsed in vivo CLSM-based cell imaging of biomarkers such as corneal sensory nerves or DCs could be a promising tool for the early detection of corneal changes in patients.…”

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confidence: 99%

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Burst of Corneal Dendritic Cells during Trastuzumab and Paclitaxel Treatment

et al. 2021

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During breast cancer therapy, paclitaxel and trastuzumab are both associated with adverse effects such as chemotherapy-induced peripheral neuropathy and other systemic side effects including ocular complications. Corneal nerves are considered part of the peripheral nervous system and can be imaged non-invasively by confocal laser scanning microscopy (CLSM) on the cellular level. Thus, in vivo CLSM imaging of structures of the corneal subbasal nerve plexus (SNP) such as sensory nerves or dendritic cells (DCs) can be a powerful tool for the assessment of corneal complications during cancer treatment. During the present study, the SNP of a breast cancer patient was analyzed over time by using large-scale in vivo CLSM in the course of paclitaxel and trastuzumab therapy. The same corneal regions could be re-identified over time. While the subbasal nerve morphology did not alter significantly, a change in dendritic cell density and an additional local burst within the first 11 weeks of therapy was detected, indicating treatment-mediated corneal inflammatory processes. Ocular structures such as nerves and dendritic cells could represent useful biomarkers for the assessment of ocular adverse effects during cancer therapy and their management, leading to a better visual prognosis.

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confidence: 99%

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confidence: 99%

Burst of Corneal Dendritic Cells during Trastuzumab and Paclitaxel Treatment

et al. 2021

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“…Because emtansine and docetaxel share a similar mechanism of action, it can be assumed that canalicular and nasolacrimal stenosis in our patient might be due to the adverse effect of emtansine. Two corneal lesions were reported as ocular adverse effects of T-DM1 administration [5, 6] based on the expression of HER2 in corneal epithelial cells and its susceptibility to trastuzumab harboring agents. In literature, two studies have reported HER2 overexpression in adenocarcinoma of lacrimal sac and nasolacrimal duct [11, 12], but not in normal nasolacrimal epithelium.…”

Section: Discussionmentioning

confidence: 99%

“…The main adverse effects are non-ocular; however, grade 1–2 ocular side effects such as conjunctivitis, swollen tear duct, increased lacrimation were reported in phase I/II clinical trials [3, 4]. Two case reports with corneal lesion induced by T-DM1 were published [5, 6], but no reports involving lacrimal drainage system have been presented so far. Herein, we report a case of lacrimal drainage system stenosis after administration of T-DM1 in advanced breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Lacrimal drainage system stenosis associated with Trastuzumab emtansine (Kadcyla®, T-DM1) administration: a case report

Kim

Choung

et al. 2019

BMC Cancer

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Background Trastuzumab emtansine (Kadcyla®, T-DM1) is an antibody-drug conjugate used to treat HER2 (human epidermal growth factor receptor 2) overexpressing metastatic breast cancer. In this report, we present the first case of lacrimal drainage system stenosis identified after T-DM1 administration, and its successful treatment with a topical steroid. Case presentation A 36-year-old female with metastatic breast cancer was referred for excessive tearing of both eyes. She previously underwent mastectomy and was treated with multiple anti-cancer regimens. However, metastases to liver and bone were identified and T-DM1 was administered. After 2 months, epiphora developed in both eyes and the patient was referred for ophthalmologic examination. The height of the tear meniscus was increased. The fluorescein dye disappearance test (FDDT) showed a delayed clearance in both eyes. Diagnostic lacrimal probing demonstrated a lower distal canalicular stenosis in both eyes. Dacryocystography indicated multiple focal narrowing of nasolacrimal duct in the right eye and diffused narrowing of nasolacrimal duct in the left eye. Topical eyedrop of tobramycin 0.3% and dexamethasone 0.1% were prescribed four times a day. After 2 months of treatment, the patient reported relief from epiphora, and the height of tear meniscus was normalized in both eyes. Conclusion T-DM1 administration in breast cancer treatment can induce lacrimal drainage system stenosis, which can be treated effectively with a topical steroid.

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“…Humanized EGFR -2 (Her 2) Corneal epithelial erosions [105] Nasolacrimal duct stenosis [106] Macular ischemia [107] Disc edema, retinal hemorrhages, retinal vascular occlusions [108]…”

Section: Trastuzumabmentioning

confidence: 99%