title: Trastuzumab-induced corneal ulceration: successful no-drug treatment of a "blind" side effect in a case report.
abstract: BACKGROUND
  We report the first successful treatment of limbal lesions and corneal erosion experienced by a breast cancer patient undergoing trastuzumab treatment.
  
  
  METHODS
  A 49-year-old Caucasian woman with early stage breast cancer was treated with adjuvant trastuzumab and subsequently showed persistent bilateral corneal marginal infiltrates resistant to topical steroid and antibiotic treatment. Autologous serum was applied in the conjunctival sac as an experimental treatment to antagonize the inhibitory effect of the HER2 receptor antibody on the corneal epithelial cells. Topical application of autologous serum led to rapid improvement of the ulcerative keratitis, with complete healing of the corneal defect after 7 days. Continued administration of the serum allowed the resumption of trastuzumab therapy without any further side effects.
  
  
  CONCLUSIONS
  Persistent bilateral corneal marginal infiltrates may occasionally arise as a side effect of trastuzumab treatment. Topical medication with autologous serum may be an effective therapeutic option for the ocular side effects of trastuzumab therapy.
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. armando.orlandi@edu.rm.unicatt.it.
authors.forename: A
authors.initials: A
authors.lastname: Orlandi
authors.affiliation: Institute of Ophthalmology, Catholic University of Sacred Heart, Rome, Italy. romina.fasciani@rm.unicatt.it.
authors.forename: R
authors.initials: R
authors.lastname: Fasciani
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. alessandra.cassano@rm.unicatt.it.
authors.forename: A
authors.initials: A
authors.lastname: Cassano
authors.affiliation: Institute of Ophthalmology, Catholic University of Sacred Heart, Rome, Italy. antonio.agresta@edu.rm.unicatt.it.
authors.forename: A
authors.initials: A
authors.lastname: Agresta
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. mariaalessandra.calegari@edu.rm.unicatt.it.
authors.forename: M A
authors.initials: MA
authors.lastname: Calegari
authors.affiliation: Institute of Ophthalmology, Catholic University of Sacred Heart, Rome, Italy. aldo.caporossi@rm.unicatt.it.
authors.forename: A
authors.initials: A
authors.lastname: Caporossi
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. carlobarone@rm.unicatt.it.
authors.forename: C
authors.initials: C
authors.lastname: Barone
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy*; D003320:Corneal Ulcer / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000068878:Trastuzumab / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D000068878:Trastuzumab