Antibody-drug conjugates (ADCs) are designed to maximize cancer cell death with lower cytotoxicity toward noncancerous cells and are an increasingly valuable option for targeted cancer therapies. However, anticancer treatment with ADCs may be associated with ocular adverse events (AEs) such as dry eye, conjunctivitis, photophobia, blurred vision, and corneal abnormalities. While the pathophysiology of ADC-related ocular AEs has not been fully elucidated, most ocular AEs are attributed to off-target effects. Product labelling for approved ADCs includes drug-specific guidance for dose modification and management of ocular AEs; however, limited data are available regarding effective strategies to minimize and mitigate ocular AEs. Overall, the majority of ocular AEs are reversible through dose modification or supportive care. Eye care providers play key roles in monitoring patients receiving ADC therapy for ocular signs and symptoms to allow for the early detection of ADC-related ocular AEs and to ensure the timely administration of appropriate treatment. Therefore, awareness is needed to help ophthalmologists to identify treatment-related ocular AEs and provide effective management in collaboration with oncologists as part of the patient's cancer care team. This review provides an overview of ocular AEs that may occur with approved and investigational ADC anticancer treatments, including potential underlying mechanisms for ADC-related ocular AEs. It also discusses clinical management practices relevant to ophthalmologists for prevention, monitoring, and management of ADC-related ocular AEs. In collaboration with oncologists, ophthalmologists play a vital role in caring for patients with cancer by assisting with the prompt recognition, mitigation, and management of treatment-related ocular AEs.

中文翻译：

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癌症中抗体-药物偶联物相关的眼部不良事件：关注病理生理学和管理策略


抗体-药物偶联物 （ADC） 旨在以较低的对非癌细胞的细胞毒性最大限度地提高癌细胞死亡率，是靶向癌症治疗越来越有价值的选择。然而，使用 ADC 进行抗癌治疗可能与眼部不良事件 （AE） 有关，例如干眼症、结膜炎、畏光、视力模糊和角膜异常。虽然 ADC 相关眼部 AE 的病理生理学尚未完全阐明，但大多数眼部 AE 归因于脱靶效应。已获批 ADC 的产品标签包括剂量调整和眼部 AE 管理的药物特异性指导;然而，关于减少和减轻眼部 AE 的有效策略的数据有限。总体而言，大多数眼部 AE 可通过剂量调整或支持性治疗来逆转。眼保健提供者在监测接受 ADC 治疗的患者的眼部体征和症状方面发挥着关键作用，以便及早发现 ADC 相关的眼部 AE 并确保及时给予适当的治疗。因此，需要提高意识来帮助眼科医生识别与治疗相关的眼部 AE，并与作为患者癌症护理团队一部分的肿瘤学家合作提供有效管理。本综述概述了已批准和在研 ADC 抗癌治疗可能发生的眼部 AE，包括 ADC 相关眼部 AE 的潜在潜在机制。它还讨论了与眼科医生预防、监测和管理 ADC 相关眼部 AE 相关的临床管理实践。 眼科医生与肿瘤学家合作，通过协助及时识别、缓解和管理与治疗相关的眼部 AE，在照顾癌症患者方面发挥着至关重要的作用。