Corneal Epitheliopathy Associated With Antibody-Drug Conjugates

Our plain-English summary of Corneal Epitheliopathy Associated With Antibody-Drug Conjugates, by S.V. Patel, L.A. Dalvin (Mayo Clinic Proceedings, 2021).

The study

• Authors: S.V. Patel, L.A. Dalvin
• Journal: Mayo Clinic Proceedings
• Published: 2021;96(7):2001-2002
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This illustrated report (a Medical Image article) described corneal epithelial changes in 3 patients receiving different antibody-drug conjugate (ADC) therapies that inhibit tubulin assembly. The authors were from the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. One patient received anetumab ravtansine for malignant pleural mesothelioma. One received ado-trastuzumab emtansine for human epidermal growth factor receptor-positive ductal carcinoma of the breast. One received belantamab mafodotin for refractory myeloma. The findings were shown in clinical photographs, including retroillumination photography and fluorescein staining. The authors explained that some ADCs cause 2 types of corneal epitheliopathy that can coexist and cause symptoms. Microcystic intraepithelial changes presumably represent apoptotic epithelial cells caused by payload toxicity to corneal epithelial stem cells at the peripheral limbus. These changes began in a peripheral annular distribution and gradually encroached on the center of the cornea. Superficial punctate epitheliopathy, detected by fluorescein staining, results from tear film dysfunction and rarely may proceed to corneal ulceration. Both types can cause blurred vision and photophobia, and the superficial type can cause ocular surface discomfort. According to the authors, symptoms and signs gradually resolve after treatment is withheld or discontinued, and the microcystic changes are replaced by regenerated normal epithelium. The authors noted that these findings are most frequent with belantamab mafodotin, which requires an ophthalmic examination before every treatment. They concluded that patients with ocular symptoms receiving similar ADCs should be assessed for corneal changes.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This "medical image" report showed eye photographs from 3 patients receiving different antibody-drug conjugates. These cancer drugs use antibodies to carry a toxic payload to cancer cells, and these ones inhibit tubulin assembly. One patient received anetumab ravtansine for malignant pleural mesothelioma, one received ado-trastuzumab emtansine for human epidermal growth factor receptor-positive ductal carcinoma of the breast, and one received belantamab mafodotin for refractory myeloma. The images showed damage to the surface layer of the cornea, the clear front of the eye. In the mesothelioma patient, microcystic changes formed a ring at the edge of the cornea. In the images from the other two patients, they had reached the center. A second type, superficial punctate epitheliopathy, was shown using fluorescein dye staining. The report gave no ages, doses or outcomes for the patients. The authors concluded that patients with eye symptoms who receive similar drugs should be assessed for corneal changes. The article did not study asbestos. Its only link to the topic is that one patient was being treated for mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: medical image report (photographs from 3 patients)
• Who was studied: 3 patients receiving antibody-drug conjugate therapies: one with malignant pleural mesothelioma, one with human epidermal growth factor receptor-positive ductal carcinoma of the breast, and one with refractory myeloma. The authors are from the Department of Ophthalmology, Mayo Clinic, Rochester, MN. No dates or patient details are given.
• Exposure: Antibody-drug conjugates that inhibit tubulin assembly: anetumab ravtansine, ado-trastuzumab emtansine and belantamab mafodotin. The report did not study any asbestos exposure.
• Main results:
  • Microcystic corneal epitheliopathy appeared in a ring around the edge of the cornea in the image from the mesothelioma patient (Figure A). In the images from the other two patients (Figures B and C), it had spread toward the center.
  • Superficial punctate epitheliopathy was shown with fluorescein staining (Figure D, from the myeloma patient).
• The authors' conclusion: The authors concluded that patients with eye symptoms who receive drugs similar to belantamab mafodotin should be assessed for corneal changes.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Trastuzumab, Carcinoma, Myeloma, STEM, Epithelium.

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• Preclinical Efficacy of an Antibody-Drug Conjugate Targeting Mesothelin Correlates with Quantitative 89Zr-ImmunoPET — A.G. Terwisscha van Scheltinga, A. Ogasawara, et al. (2017)
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• Antibody drug conjugates in thoracic malignancies — J.M. Pacheco, D.R. Camidge (2018)
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