Bilateral Severe Corneal Ulcer in a Patient with Lung Adenocarcinoma Treated with Gefitinib

Gozzi, Fabrizio; Tiseo, Marcello; Facchinetti, Francesco; Gandolfi, Stefano; Rubino, Pierangela

doi:10.1159/000514696

Cited by 7 publications

(10 citation statements)

References 12 publications

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“…Epithelial growth factor, ligand of the EGFR, is secreted from the lacrimal glands and found in high concentration in tears [10]. It has an important role in ocular surface homeostasis such as promoting migration and proliferation of epithelial cells [1]. The EGFR is expressed on the basal cell layer of human corneal, limbal, and conjunctival epithelium, and also in epithelial cells of skin, glands, and hair follicles.…”

Section: Discussionmentioning

confidence: 99%

“…Epidermal growth factor receptor (EGFR) is a molecule expressed in many tissues, including the ocular surface and periocular adnexal structures. Its main physiological function is to regulate epithelial tissue development and homeostasis [1]. In recent years, EGFR inhibitors (EGFR-Is) have become an important treatment for many malignant solid tumor patients, especially in non-small cell lung cancers (NSCLC) [2].…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED ARTICLE: Tarsoconjunctival Granulation Tissue Formation Associated with EGFR Inhibitors

et al. 2022

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The combination of amivantamab, an epidermal growth factor receptor (EGFR)-MET bispecific antibody, with the third-generation tyrosine kinase inhibitor lazertinib is used to overcome drug resistance in the treatment of non-small cell lung carcinoma (NSCLC). We present a 58-year-old woman with NSCLC who developed tarsoconjunctival granulation tissue while she was under amivantamab-lazertinib combination therapy. After the excision of tarsoconjunctival granulation tissue, she was maintained on amivantamab-lazertinib combination therapy. Tarsoconjunctival lesions recurred and she also developed trichomegaly and paronychia, which are well-known side effects of EGFR inhibitors. This case presentation aims to raise awareness among ophthalmologists and oncologists of the association between EGFR-Is and an unusual side effect; tarsoconjunctival granulation tissue formation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Tarsoconjunctival Granulation Tissue Formation Associated with EGFR Inhibitors

et al. 2022

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“…The effects of the different therapies of cerebral tumors such as surgery ( 19 – 22 ) radiotherapy, ( 23 ) and systemic chemotherapy ( 24 , 25 ) may also alter the nerve fibers or induce limbal stem cell deficiency ( 26 , 27 ) resulting clinically in NK.…”

Section: Discussionmentioning

confidence: 99%

Neurotrophic Keratopathy in Systemic Diseases: A Case Series on Patients Treated With rh-NGF

et al. 2022

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PurposeTo evaluate the prevalence, clinical ocular presentation and corneal healing in moderate and severe neurotrophic keratopathy (NK) caused by systemic diseases and treated with rh-NGF.SettingDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Italy.DesignRetrospective observational study of case series.Materials and MethodsIn this retrospective observational study 11 patients (five female and six males) aged from 24 to 88 years (55.4 ± 21.3 years) with moderate and severe NK caused by systemic diseases were enrolled. The VAS questionnaire was dispensed. The ocular examination comprised slit lamp evaluation, ocular surface assessment with Keratograph 5M (Oculus, Germany), corneal sensitivity with Cochet-Bonnet esthesiometer (Lunneaux, France) and corneal thickness measurement with AC-OCT (DRI, Triton, Topcon, Japan). The underlying systemic causes of NK were determined.ResultsThe main cause of NK was post-neuroma surgery (36%), followed by diabetes (18%). The remaining causes were rheumatoid arthritis (9%), post-traumatic (9%), post-surgery (9%), atopia (9%), Graves' disease (9%). Seven eyes presented severe grade of NK with corneal ulcer and in four a moderate grade was registered. The rh-NGF (Cenegermin) was administered with a standard protocol one drop six times daily for 8 weeks. The complete healing of all corneal defects was registered at the end of the treatment.ConclusionsThe post-neuroma surgery was the most common cause of NK and severe grade was clinically more represented. The rh-NGF proved effective to promote corneal recovery with all defects healed after the treatment.

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“…There are previous case reports in which patients of higher age groups presented with corneal ulceration and thinning within three months of gefitinib therapy [ 6 , 7 ]. This case differs in that a young female on gefitinib for two years presented with only mild ocular symptoms.…”

Section: Discussionmentioning

confidence: 99%

Ocular Adverse Effects of Gefitinib: A Case Report

Jeria¹,

Thool²,

Daigavane³

et al. 2022

Cureus

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Gefitinib is a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. It is used for treating locally advanced or metastatic non-small cell lung carcinoma and is well tolerated systemically. However, sight-threatening ocular adverse effects, like corneal ulcer and perforation, can occur due to the expression of EGFR on limbal and conjunctival epithelia. In this report, we describe a case of a 36-year-old female who presented with loss of eyebrow hair and eyelashes of both eyes and blurring of vision in the right eye. On ocular examination, the patient had anterior blepharitis, madarosis, punctuate epithelial erosions and reduced corneal sensation in both eyes, and corneal thinning in the right eye. On specular microscopy, there was decreased central corneal thickness in both eyes. Treatment with topical antibiotics and lubricating drops led to the resolution of blepharitis and punctate epithelial erosions. This case report aims to create awareness among ophthalmologists and oncologists about the early detection of gefitinib-related ocular adverse effects and timely intervention in patients.

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Bilateral Severe Corneal Ulcer in a Patient with Lung Adenocarcinoma Treated with Gefitinib

Cited by 7 publications

References 12 publications

RETRACTED ARTICLE: Tarsoconjunctival Granulation Tissue Formation Associated with EGFR Inhibitors

RETRACTED ARTICLE: Tarsoconjunctival Granulation Tissue Formation Associated with EGFR Inhibitors

Neurotrophic Keratopathy in Systemic Diseases: A Case Series on Patients Treated With rh-NGF

Ocular Adverse Effects of Gefitinib: A Case Report

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