Boucher Rafael, Delaye Matthieu, Haigh Oscar, Barreau Emmanuel, Medkour Karima, Labetoulle Marc, Rousseau Antoine
Service d'ophtalmologie, CHU de Bicêtre, Assistance publique, Hopitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France.
Service d'oncologie digestive, département d'oncologie médicale, Gustave-Roussy, Villejuif, France.
Bull Cancer. 2025 May;112(5):542-549. doi: 10.1016/j.bulcan.2025.02.004. Epub 2025 Mar 18.
New anticancer strategies increasingly rely on targeted therapies, which maximize anticancer activity while reducing toxicity to healthy cells. These modern anticancer therapies (MATs) mainly include immune checkpoint inhibitors (ICIs), antibody drug conjugates (ADCs) and targeted anticancer therapies (TATs) which inhibit signal transduction pathways. These new molecules are associated with a wide range of ocular adverse events (OAEs), of varying severity: from ocular surface irritation to irreversible vision loss. ICIs can trigger autoimmune responses in all eye tissues. ADCs mainly cause ocular surface toxicity, the most specific of which being microcyst-like epithelial changes (MECs). TATs cause a wide range of OAEs, depending on their class. Oncologists and ophthalmologists will be increasingly confronted to these OAEs - some of which are still poorly characterized - as the number of prescribed NTAs increases. Close collaboration between specialists is essential for their early identification and management, which helps reduce visual and quality of life consequences for these patients. This review addresses the clinical characteristics of the main OAEs linked to MATs, the description of the suspected underlying pathophysiological mechanisms and the key points of their management.
新的抗癌策略越来越依赖于靶向治疗,这种治疗方式在降低对健康细胞毒性的同时,能使抗癌活性最大化。这些现代抗癌疗法(MATs)主要包括免疫检查点抑制剂(ICIs)、抗体药物偶联物(ADCs)以及抑制信号转导通路的靶向抗癌疗法(TATs)。这些新分子与一系列严重程度各异的眼部不良事件(OAEs)相关:从眼表刺激到不可逆的视力丧失。ICIs可在所有眼组织中引发自身免疫反应。ADCs主要导致眼表毒性,其中最具特异性的是微囊样上皮改变(MECs)。TATs根据其类别会引发多种OAEs。随着处方新型抗癌疗法(NTAs)数量的增加,肿瘤学家和眼科医生将越来越多地面对这些眼部不良事件——其中一些仍未得到充分描述。专家之间的密切合作对于早期识别和管理这些事件至关重要,这有助于减少对这些患者视力和生活质量的影响。本综述阐述了与MATs相关的主要OAEs的临床特征、对可疑潜在病理生理机制的描述以及管理要点。