Ocular side effects of antibody–drug conjugates for cancer treatment

BACKGROUND: Antibody-drug conjugates (ADCs) are approved for use in treating certain types of cancer and are now in clinical development for many others, as they are therapeutically effective. Some of these agents commonly cause ocular side effects, typically manifesting themselves as blurred vision or a foreign-body sensation. METHODS: For this narrative review of the literature, we carried out a database search and a cross-reference search at the German Federal Institute for Drugs and Medical Devices (BfArM) to identify publications on the diagnosis, prevention, and treatment of ocular side effects associated with ADCs. RESULTS: Of the 13 ADCs that have been approved to date, 4 cause ocular side effects in 5% to 89% of patients. Ocular side effects are severe in up to 43% of the cases in which they occur. Appropriate prophylactic measures must be taken to limit their frequency and intensity; these include not wearing contact lenses, using lubricating eye drops multiple times a day, and cooling the eyes during the administration of treatment. Severe ocular side effects can arise despite such measures and require treatment by a specialist. Ocular side effects can be managed successfully by rapid detection and adequate evaluation of their extent followed by proper treatment, thereby enabling the patient's cancer to be treated appropriately. CONCLUSION: Interdisciplinary collaboration between oncologists and ophthalmologists must be well-coordinated to ensure effective oncological treatment.