Scandurra Giuseppa, Marano Filippo, Gebbia Vittorio, Valerio Maria Rosaria, Sambataro Daniela, Lombardo Valentina, Angelico Giuseppe, Scollo Paolo, Scibilia Giuseppe, Pizzo Alessandra
Oncology Unit, Cannizzaro Hospital, 95126, Catania, Italy.
Medicine and Surgery, Kore University, 94100, Enna, Italy.
Clin Transl Oncol. 2025 Sep 9. doi: 10.1007/s12094-025-04050-5.
Antibody-drug conjugates (ADCs) represent a promising therapeutic approach in gynecologic cancers, particularly ovarian and cervical malignancies. Agents such as mirvetuximab soravtansine, and tisotumab vedotin, targeting folate receptor alpha and tissue factor, respectively, reported clinical efficacy in patients with limited options. However, their use is associated with ocular toxicities, including keratopathy, blurred vision, and dry eye, which may impact adherence and quality of life. This review summarizes current evidence on the incidence, pathophysiology, and clinical presentation of ADC-related ocular adverse events in gynecologic oncology. It also provides practical, evidence-based strategies for the prevention, monitoring, and management of these adverse events. Interventions include prophylactic topical therapies, supportive care measures, treatment delays or dose modifications, and herpes zoster vaccination. Comprehensive management of ocular toxicities is essential to ensure the safe and sustained use of ADCs, preserving both therapeutic benefit and patient well-being. Further research is warranted to optimize preventive and management protocols.
抗体药物偶联物（ADC）是妇科癌症，尤其是卵巢癌和宫颈癌中一种有前景的治疗方法。分别靶向叶酸受体α和组织因子的药物，如 mirvetuximab soravtansine 和 tisotumab vedotin，在选择有限的患者中显示出临床疗效。然而，它们的使用与眼部毒性有关，包括角膜病变、视力模糊和干眼，这可能会影响依从性和生活质量。本综述总结了妇科肿瘤学中 ADC 相关眼部不良事件的发生率、病理生理学和临床表现的当前证据。它还提供了预防、监测和管理这些不良事件的实用、基于证据的策略。干预措施包括预防性局部治疗、支持性护理措施、治疗延迟或剂量调整以及带状疱疹疫苗接种。眼部毒性的综合管理对于确保 ADC 的安全和持续使用至关重要，既能保留治疗益处又能保障患者福祉。有必要进行进一步研究以优化预防和管理方案。
