Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
Eur J Ophthalmol. 2021 May;31(3):1391-1398. doi: 10.1177/1120672120930688. Epub 2020 May 31.
To examine the nature and frequency of ocular side effects due to systemic target therapy with BRAF and MEK inhibitors as well as immunotherapy with cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1) monoclonal antibodies used in the treatment of cutaneous malignant melanoma (CMM).
While proven effective in cancer treatment, target therapy and immunotherapy have been associated with ocular side effects likely due to their ability to alter the immune privilege of the eye. We conducted a retrospective chart review of patients undergoing target and immunotherapy for CMM and documented all associated eye findings.
We reviewed the records of 34 patients receiving target and immunotherapy for CMM who were examined in the academic ophthalmology clinic between 2012 and 2017.
Ocular side effects were present in 41.1% of patients in this study with 14.7% presenting with uveitis. Patients undergoing therapy with either vemurafenib only or dabrafenib/trametinib combination therapies comprised 70.5% of the study cohort. Ocular side effects occurred in 45.5% and 46.1% of patients on vemurafenib and dabrafenib/trametinib combination therapy, respectively. About 47.5% of males presented with ocular side effects compared to 30.5% of females. Notably, 13/14 patients with ocular symptoms recovered.
This study highlights the frequency of ocular side effects in patients treated with target therapy and immunotherapy for CMM and shows that symptom resolution can be effectively achieved with proper ophthalmic care. Further research is required to answer whether cessation of these therapies is mandatory during ophthalmic treatment.
检查由于 BRAF 和 MEK 抑制剂的全身靶向治疗以及细胞毒性 T 淋巴细胞抗原 4（CTLA-4）和程序性细胞死亡 1（PD-1）单克隆抗体的免疫治疗而导致的眼部副作用的性质和频率，这些治疗方法用于治疗皮肤恶性黑色素瘤（CMM）。
虽然靶向治疗和免疫治疗已被证明在癌症治疗中有效，但它们与眼部副作用有关，可能是因为它们能够改变眼睛的免疫特权。我们对接受 CMM 的靶向和免疫治疗的患者进行了回顾性图表审查，并记录了所有相关的眼部发现。
我们回顾了 2012 年至 2017 年在学术眼科诊所接受 CMM 靶向和免疫治疗的 34 名患者的记录。
在本研究中，41.1%的患者存在眼部副作用，14.7%的患者患有葡萄膜炎。接受维莫非尼或达拉非尼/曲美替尼联合治疗的患者分别占研究队列的 70.5%和 70.5%。接受维莫非尼和达拉非尼/曲美替尼联合治疗的患者中，分别有 45.5%和 46.1%出现眼部副作用。与 30.5%的女性相比，约 47.5%的男性出现眼部副作用。值得注意的是，13/14 名有眼部症状的患者恢复。
本研究强调了 CMM 患者接受靶向治疗和免疫治疗后眼部副作用的频率，并表明通过适当的眼科护理可以有效地实现症状缓解。需要进一步研究来回答在眼科治疗期间是否必须停止这些治疗。
