Ophthalmic adverse effects of taxanes: The Mayo Clinic experience

Abstract

Purpose: To investigate ophthalmic side effects of taxanes and compare side effect frequency, requirement for cessation of taxane therapy, visual acuity outcome, and concurrent systemic effects between paclitaxel and docetaxel. Methods: Patients taking taxanes at a single center from 1/1/2010 to 2/29/2020 were retrospectively reviewed for clinical characteristics, treatments, and concurrent systemic adverse effects. Results: Of 1918 patients, 22 (1.1%) experienced an ophthalmic side effect that came to the attention of an eye care provider. Mean age at presentation of the side effect was 62 years (median 66, range 23–82). The most common side effect was meibomian gland dysfunction in 5 (23%) patients, followed by cystoid macular edema in 4 (18%) patients and canalicular obstruction in 4 (18%) patients, followed by diplopia in 2 (9%) patients, and singular cases of lash alopecia, and blepharitis, among others. Lids/lashes as well as nasolacrimal duct adverse effects occurred more frequently with docetaxel therapy than with paclitaxel therapy. Follow-up was available in 10 (45%) patients, with mean duration of 5 months (median 4, range 0–12 months). Of these patients, the ophthalmic side effects were resolved or controlled without discontinuing therapy in 8 (80%) patients. Taxane cessation was required in one patient with docetaxel-related canalicular obstruction and one patient with paclitaxel-related cystoid macular edema. Conclusion: Ophthalmic taxane-related adverse events are rare with estimated frequency of ophthalmic side effects of about 1%. Nevertheless, it is important that ophthalmologists recognize the range of side effects for optimal management. Most ophthalmic events can be treated with targeted therapy without discontinuation of life-prolonging taxane therapy.

Analyses of Ocular Adverse Reactions Associated With Anticancer Drugs Based on the Japanese Pharmacovigilance Database

“…However, we reveal important data linking safety signals for lens disorders with venetoclax use. Combination therapy with BRAF/MEK inhibitors such as encorafenib/bimetinib and dabrafenib/ reported that taxanes such as paclitaxel, nab-paclitaxel, and docetaxel induce macular edema at a low frequency(42,43).Our results suggest that nab-paclitaxel and paclitaxel may increase the risk of retinal damage. In our study, blinatumomabTanaka et al: Ocular Adverse Reactions Associated With Anticancer Drugs 4445…”

Bilateral intermediate uveitis following treatment with paclitaxel in a patient with invasive ductal carcinoma of the breast

“…Paclitaxel-based chemotherapy is known to cause ocular side effects including meibomian gland dysfunction [ 4 ], canalicular obstruction [ 4 ], diplopia [ 4 ], keratitis [ 9 ], CME [ 10 ], scintillating scotoma [ 11 ], and possibly glaucoma [ 12 , 13 ]. Das et al .…”

“…Non-ocular taxane-associated adverse effects include, but are not limited to, hypersensitivity reactions, myelosuppression and immunocompromise, neurotoxicity, cardiac toxicity, and myalgia [ 3 ]. Ocular side effects are seen in 1.1% of patients receiving taxanes [ 4 ].…”

Intravitreal Ranibizumab Had Limited Effect on Cystoid Macular Edema Due to Albumin-Bound Paclitaxel: A Case Report and Literature Review

“…T-CME is a rare side effect of taxanes, with an incidence of about 0.2–0.5% ( 3 , 4 ). The first case of T-CME was reported in 2003, caused by docetaxel ( 29 ).…”

“…Albumin-bound paclitaxel (nab-paclitaxel, Abraxane) is an albumin-stabilized paclitaxel nanoparticle formulation with potent antitumor effects than paclitaxel in metastatic breast cancer that has failed combination chemotherapy or recurred within 6 months of adjuvant chemotherapy ( 2 ). Cystoid macular edema (CME) is a rare complication caused by nab-paclitaxel ( 3 , 4 ). Here we report the first case of nab-paclitaxel-induced CME treated with intravitreal ranibizumab (IVR) and review the literature about nab-paclitaxel-related CME.…”