title: Emerging toxicities in the treatment of non-small cell lung cancer: ocular disorders.
abstract: The treatment of advanced disease (stage IIIb and IV) of non-small cell lung cancer (NSCLC) is based on systemic treatment with platinum-based chemotherapy or biological compounds depending on the disease molecular profile. In the last few years, intensive investigational efforts in anticancer therapy have led to the registration of new active chemotherapeutic agents, combination regimens, and biological drugs, expanding choices for customizing individual treatment. However, the introduction of new drugs in the clinical setting has led to several new toxicities, creating some difficulties in daily management. Among these, ocular toxicity is generally overlooked as more common toxicities such as myelosuppression, stomatitis, diarrhea, vomiting, "hand-foot syndrome", and neurological alterations attract greater attention. Ophthalmic complications from cytotoxic chemotherapeutics are rare, transient, and of mild/moderate intensity but irreversible acute disorders are possible. The best way to prevent potential irreversible visual complications is an awareness of the potential for ocular toxicity because dose reductions or early drug cessation can prevent serious ocular complications in the majority of cases. However, given the novelty of many therapeutic agents and the complexity of ocular pathology, oncologists may be unfamiliar with these adverse effects of anticancer therapy. Although toxicities from chemotherapy are generally intense but short lasting, toxicities related to targeted drugs are often milder but longer lasting and can persist throughout treatment. Here we review the principal clinical presentations of ocular toxicity arising from chemotherapy [1-3], target therapies [4], and newly developed drugs and provide some recommendations for monitoring and management of ocular toxicity.
authors.affiliation: Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Agustoni
authors.forename: Marco
authors.initials: M
authors.lastname: Platania
authors.forename: Milena
authors.initials: M
authors.lastname: Vitali
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Zilembo
authors.forename: Eva
authors.initials: E
authors.lastname: Haspinger
authors.forename: Valentina
authors.initials: V
authors.lastname: Sinno
authors.forename: Rosaria
authors.initials: R
authors.lastname: Gallucci
authors.forename: Filippo
authors.initials: F
authors.lastname: de Braud
authors.forename: Marina Chiara
authors.initials: MC
authors.lastname: Garassino
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D005123:Eye / Q000187:drug effects / Q000473:pathology; D005128:Eye Diseases / Q000139:chemically induced*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D058990:Molecular Targeted Therapy; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors
keywords: Chemotherapy; Non-small-cell lung cancer; Ocular toxicity; Ophthalmology; Target therapies