Persistent corneal epithelial defect associated with erlotinib treatment.
OBJECTIVE
To report a case of persistent corneal epithelial erosion in a patient undergoing treatment with erlotinib for her lung cancer.


METHODS
Report of a 79-year-old woman who presented with a persistent corneal epithelial defect associated with infectious keratitis that waxed and waned for 5 months despite treatment. She had been diagnosed with lung cancer and was being treated with erlotinib, a reversible epidermal growth factor receptor (EGFR) inhibitor.


RESULTS
The keratitis required a biopsy to establish the diagnosis of Staphylococcus epidermidis keratitis. The infectious keratitis was successfully treated; however, her pain and the epithelial defect persisted. She discontinued the erlotinib treatment. Within 2 weeks, the abrasion healed and had no recurrence.


CONCLUSIONS
This report is, to our knowledge, the first description of a nonhealing corneal erosion and infectious keratitis possibly associated with erlotinib toxicity. EGFR is expressed in basal epithelial cells across the cornea and limbal basal cells; it is considered imperative for corneal epithelial cell proliferation and wound healing. Erlotinib is mediated through inhibition of EGFR, which is a highly promising area in molecularly targeted chemotherapies. It will become increasingly important for ophthalmologists to recognize and treat side effects of chemotherapies interfering with the epithelial growth factor pathway.
Johnson
Keegan S
KS
Department of Ophthalmology and Visual Science New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, USA.
Levin
Flora
F
Chu
Davis S
DS
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects; D003316:Corneal Diseases / Q000139:chemically induced* / Q000473:pathology; D019573:Epithelium, Corneal / Q000187:drug effects* / Q000473:pathology; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology; D008175:Lung Neoplasms / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000209:etiology; D013212:Staphylococcus epidermidis
D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride