PDF(Pubmed)
Abstract：
UNASSIGNED: Programmed cell death-1 (PD-1) inhibitors and anti-angiogenic drugs have become a hotspot in research of anti-tumor programs; however, they can also cause some rare drug-related adverse reactions. Immune checkpoint inhibitors (ICIs) cause adverse reactions in the body, collectively known as immune-related adverse events (irAEs). Ocular side effects can occur in both targeted and immunotherapy patients, including dry eye, blurred vision, uveitis, conjunctivitis, retinopathy, or thyroid eye disease. To our knowledge, this is the first case report describing corneal ulcers secondary to dry eye in a patient treated with the combination of PD-1 inhibitor sintilimab and multi-targeted receptor tyrosine kinase inhibitor (TKI) anlotinib.
UNASSIGNED: A 65-year-old woman with non-small cell lung cancer (NSCLC) and bone metastases, without pre-existing ocular conditions, experienced mild dry eye symptoms 1 month following treatment with sintilimab (200 mg q3w) in combination with anlotinib (12 mg q3w). Unrelieved dry eye symptoms occurred after the third cycle of chemotherapy, and she was diagnosed with dry eye syndrome. Subsequently, she received corneal protective lens, sodium hyaluronate eye drops, and prednisone treatment. Her corneal epithelial damage did not improve significantly, and within the following 2 months, her vision decreased in both eyes and progressed to bilateral corneal ulcers. Oral administration of sintilimab and anlotinib was interrupted, and treatments such as corticosteroids, anti-inflammatory drugs, and corneal repair were administered; however, both eyes presented with corneal subepithelial defect and corneal scarring. Due to a shortage of donors, no corneal transplantation surgery could be performed.
UNASSIGNED: The development of corneal epithelial disorders in patients receiving target therapy and immunotherapy may not be reversed by reducing its dose. Although the condition is controlled with the use of glucocorticoids, some eye side effects cannot be cured. The timely detection and intervention of adverse effects of anti-tumor drugs by oncologists and ophthalmologists is critical for rational prescription. Ophthalmologists should be aware of eye side effects in patients using immunotherapy to ensure appropriate treatment and minimize potential eye complications such as dry eye, conjunctivitis, etc.
UNASSIGNED: A 65-year-old woman with non-small cell lung cancer (NSCLC) and bone metastases, without pre-existing ocular conditions, experienced mild dry eye symptoms 1 month following treatment with sintilimab (200 mg q3w) in combination with anlotinib (12 mg q3w). Unrelieved dry eye symptoms occurred after the third cycle of chemotherapy, and she was diagnosed with dry eye syndrome. Subsequently, she received corneal protective lens, sodium hyaluronate eye drops, and prednisone treatment. Her corneal epithelial damage did not improve significantly, and within the following 2 months, her vision decreased in both eyes and progressed to bilateral corneal ulcers. Oral administration of sintilimab and anlotinib was interrupted, and treatments such as corticosteroids, anti-inflammatory drugs, and corneal repair were administered; however, both eyes presented with corneal subepithelial defect and corneal scarring. Due to a shortage of donors, no corneal transplantation surgery could be performed.
UNASSIGNED: The development of corneal epithelial disorders in patients receiving target therapy and immunotherapy may not be reversed by reducing its dose. Although the condition is controlled with the use of glucocorticoids, some eye side effects cannot be cured. The timely detection and intervention of adverse effects of anti-tumor drugs by oncologists and ophthalmologists is critical for rational prescription. Ophthalmologists should be aware of eye side effects in patients using immunotherapy to ensure appropriate treatment and minimize potential eye complications such as dry eye, conjunctivitis, etc.
摘要：
■程序性细胞死亡-1(PD-1)抑制剂和抗血管生成药物已成为抗肿瘤方案研究的热点;它们也会引起一些罕见的药物相关不良反应。免疫检查点抑制剂（ICIs）在体内引起不良反应，统称为免疫相关不良事件（irAE）。眼部副作用可能发生在靶向和免疫治疗患者中，包括干眼症,视力模糊,葡萄膜炎,结膜炎,视网膜病变,或甲状腺眼病。据我们所知,这是首例病例报告,描述1例接受PD-1抑制剂辛替单抗和多靶向受体酪氨酸激酶抑制剂(TKI)安洛替尼联合治疗的患者继发于干眼的角膜溃疡.
■一名65岁女性患有非小细胞肺癌（NSCLC）和骨转移，没有预先存在的眼部疾病，在使用辛替尼（200mgq3w）与安洛替尼（12mgq3w）联合治疗1个月后出现轻度干眼症状。第3周期化疗后出现未缓解的干眼症状，她被诊断出患有干眼症.随后，她接受了角膜保护镜,透明质酸钠滴眼液，和泼尼松治疗。她的角膜上皮损伤没有明显改善，在接下来的两个月内，她的双眼视力下降，进展为双侧角膜溃疡。口服辛替利玛和安洛替尼被中断，和皮质类固醇等治疗方法，抗炎药,和角膜修复；然而，双眼均出现角膜上皮下缺损和角膜瘢痕。由于捐助者的短缺，无法进行角膜移植手术.
■接受靶向治疗和免疫治疗的患者角膜上皮疾病的发展可能无法通过减少剂量来逆转。尽管使用糖皮质激素可以控制病情，一些眼睛副作用无法治愈。肿瘤学家和眼科医生及时发现和干预抗肿瘤药物的不良反应是合理处方的关键。眼科医生应该意识到使用免疫疗法的患者的眼睛副作用，以确保适当的治疗并最大程度地减少干眼症等潜在的眼部并发症，结膜炎,等。
■一名65岁女性患有非小细胞肺癌（NSCLC）和骨转移，没有预先存在的眼部疾病，在使用辛替尼（200mgq3w）与安洛替尼（12mgq3w）联合治疗1个月后出现轻度干眼症状。第3周期化疗后出现未缓解的干眼症状，她被诊断出患有干眼症.随后，她接受了角膜保护镜,透明质酸钠滴眼液，和泼尼松治疗。她的角膜上皮损伤没有明显改善，在接下来的两个月内，她的双眼视力下降，进展为双侧角膜溃疡。口服辛替利玛和安洛替尼被中断，和皮质类固醇等治疗方法，抗炎药,和角膜修复；然而，双眼均出现角膜上皮下缺损和角膜瘢痕。由于捐助者的短缺，无法进行角膜移植手术.
■接受靶向治疗和免疫治疗的患者角膜上皮疾病的发展可能无法通过减少剂量来逆转。尽管使用糖皮质激素可以控制病情，一些眼睛副作用无法治愈。肿瘤学家和眼科医生及时发现和干预抗肿瘤药物的不良反应是合理处方的关键。眼科医生应该意识到使用免疫疗法的患者的眼睛副作用，以确保适当的治疗并最大程度地减少干眼症等潜在的眼部并发症，结膜炎,等。
