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‘Be intentional, aggressive’ with ocular effects of cancer drugs

Healio Optometry4d ago1 min read

PHOENIX — Mirvetuximab, an antibody drug conjugate for the treatment of certain types of cancer, can lead to adverse ocular events in the early weeks of treatment, according to a poster here.Across four cases of folate receptor-alpha positive, platinum-resistant epithelial ovarian and fallopian tube cancer, three patients developed corneal subepithelial microcysts in the early weeks of treatment with Elahere (mirvetuximab, AbbVie).Other findings included superficial punctate keratitis, epithelial ridge, stromal haze and posterior subcapsular cataract.“For most, the initial presentation was in

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AI Summary

Quick Take

Mirvetuximab (Elahere), an antibody-drug conjugate for ovarian cancer, is linked to early-onset adverse ocular events, most notably corneal subepithelial microcysts. In a case series of four patients, three developed these microcysts within the first few weeks of treatment, highlighting the need for rapid clinical intervention.

Why It Matters

Antibody-drug conjugates (ADCs) like Elahere are becoming more common in oncology, but they frequently carry significant ocular toxicity profiles that necessitate close co-management between oncology and eye care. Because these ocular side effects often appear in the very early stages of treatment, eye care providers must be prepared to manage the ocular surface aggressively to prevent vision loss or the need for oncology treatment interruptions. This is particularly vital for patients with platinum-resistant cancers who have limited systemic treatment options.

Key Findings

Three out of four patients treated with mirvetuximab developed corneal subepithelial microcysts during the initial weeks of therapy.
Clinical findings beyond microcysts included superficial punctate keratitis, epithelial ridges, and stromal haze.
One patient in the series was diagnosed with a posterior subcapsular cataract during the course of treatment.
The ocular adverse events were observed specifically in patients being treated for folate receptor-alpha positive, platinum-resistant epithelial ovarian and fallopian tube cancers.

Study Snapshot

Design

Case series (poster presentation)

Population

Patients with folate receptor-alpha positive, platinum-resistant epithelial ovarian and fallopian tube cancer

Sample Size

4 patients

Practice Implications

Clinicians should prioritize baseline ocular exams and frequent monitoring during the first month of Elahere therapy to catch corneal changes early. Aggressive management of the ocular surface is necessary to mitigate symptoms of keratitis and microcysts, ensuring patients can remain compliant with their oncologic regimen.

Who's Affected

Cornea SpecialistsComprehensive OphthalmologistsOptometristsOcular Oncologists

Evidence StrengthPreliminary

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