A clinical case of the development of choroidal neovascularization in a patient with skin melanoma on the background of therapy with MEK and BRAF inhibitors

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅存取

详细

The emergence of targeted therapy has become a significant breakthrough in the management of cancer patients, but even it is not without drawbacks. The article describes a clinical case of the development choroidal neovascularization in a 42-year-old patient with stage IV skin melanoma during 15 months of therapy with MEK and BRAF inhibitors. Clinicians need to remember that such patients may have not only MEK-associated retinopathy, but also other pathological changes in the retina, in particular choroidal neovascularization, which may be associated with both the chemotherapy they receive and the paraneoplastic syndrome itself against the background of the course of the underlying disease. Timely diagnosis and adequate management tactics allow such patients to preserve visual functions.

作者简介

Natalia Tkachenko

Pavlov First St. Petersburg State Medical University

Email: natalyatkachenko@yandex.ru
SPIN 代码: 5187-3670

Cand. Sci. (Med.)

俄罗斯联邦, Saint Petersburg

Svetlana Belekhova

Pavlov First St. Petersburg State Medical University

编辑信件的主要联系方式.
Email: beleksv@yandex.ru
ORCID iD: 0000-0003-0293-4811
SPIN 代码: 3637-7441

Cand. Sci. (Med.)

俄罗斯联邦, Saint Petersburg

Natalia Zhukova

Saint Petersburg State University; City Clinical Oncological Dispensary

Email: drnvz@yandex.ru
ORCID iD: 0000-0002-0619-2205
SPIN 代码: 3480-2098

Cand. Sci. (Med.), Assistant professor, Head of the Chemotherapeutic Department

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Vera Prokopchuk

Pavlov First St. Petersburg State Medical University

Email: prokopchuk.vera98@gmail.com
ORCID iD: 0000-0003-3310-6234

Student

俄罗斯联邦, Saint Petersburg

Natalya Chernova

Almazov National Medical Research Centre

Email: demod@list.ru

Ophthalmologist

俄罗斯联邦, Saint Petersburg

参考

  1. Gianni L, Panzini I, Li S, et al. Ocular toxicity during adjuvant chemoendocrine therapy for early breast cancer: results from International Breast Cancer Study Group trials. Cancer. 2006;106(3):505–513. doi: 10.1002/cncr.21651
  2. Bindiganavile S, Bhat N, Lee AG, et al. Targeted Cancer Therapy and Its Ophthalmic Side Effects: A Review. J Immunother Precis Oncol. 2021;4(1):6–15. doi: 10.36401/JIPO-20-21
  3. Ho WL, Wong H, Yau T. The ophthalmological complications of targeted agents in cancer therapy: what do we need to know as ophthalmologists? Acta Ophthalmol. 2013;91(7):604–609. doi: 10.1111/j.1755-3768.2012.02518
  4. Liu СY, Francis JH, Abramson DH. Ocular side effects of systemically administered chemotherapy [Internet]. UpToDate, 2022. Available from: https://www.uptodate.com/contents/ocular-side-effects-of-systemically-administered-chemotherapy/print
  5. Camidge DR, Bang Y-J, Kwak EL, et al. Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: updated results from a phase 1 study. Lancet Oncol. 2012;13(10):1011–1019. doi: 10.1016/S1470-2045(12)70344-3
  6. Saleh M, Bourcier T, Noel G, et al. Bilateral macular ischemia and severe visual loss following trastuzumab therapy. Acta Oncol. 2011;50(3):477–478. doi: 10.3109/0284186X.2011.555781
  7. De la Cruz-Merino L., Di Guardo L., Grob J.-J., et al. Clinical features of serous retinopathy observed with cobimetinib in patients with BRAF-mutated melanoma treated in the randomized coBRIM study // J Transl Med. 2017. Vol. 15. ID146. doi: 10.1186/s12967-017-1246-0
  8. Stjepanovic N, Velazquez-Martin JP, Bedard PL. Ocular toxicities of MEK inhibitors and other targeted therapies. Ann Oncol. 2016;27(6):998–1005. doi: 10.1093/annonc/mdw100
  9. Méndez-Martínez S, Calvo P, Ruiz-Moreno O, et al. Ocular adverse events associated with MEK inhibitors. Retina. 2019;39(8):1435–1450. doi: 10.1097/IAE.0000000000002451
  10. Urner-Bloch U, Urner M, Jaberg-Bentele N, et al. MEK inhibitor-associated retinopathy (MEKAR) in metastatic melanoma: Long-term ophthalmic effects. Eur J Cancer. 2016;65:130–138. doi: 10.1016/j.ejca.2016.06.018
  11. Francis JH, Habib LA, Abramson DH, et al. Clinical and Morphologic Characteristics of MEK Inhibitor-Associated Retinopathy: Differences from Central Serous Chorioretinopathy. Ophthalmology. 2017;124(12):1788–1798. doi: 10.1016/j.ophtha.2017.05.038
  12. De la Cruz-Merino L, Di Guardo L, Grob JJ, et al. Clinical features of serous retinopathy observed with cobimetinib in patients with BRAF-mutated melanoma treated in the randomized coBRIM study. J Transl Med. 2017;15:146. doi: 10.1186/s12967-017-1246-0
  13. Tyagi P, Santiago C. New features in MEK retinopathy. BMC Ophthalmol. 2018;18:221. doi: 10.1186/s12886-018-0861-8
  14. Albertini GC, Corbelli E, Battaglia Parodi M, Bandello F. Choroidal Neovascularization in Multifocal Choroiditis after Dabrafenib and Trametinib. Eur J Ophthalmol. 2017;27(6):e184–e186. doi: 10.5301/ejo.5001013
  15. Modjtahedi BS, Maibach H, Park S. Multifocal bilateral choroidal neovascularization in a patient on ipilimumab for metastatic melanoma. Cutan Ocul Toxicol. 2013;32(4):341–343. doi: 10.3109/15569527.2013.781618
  16. Al-Tweigeri T, Nabholtz J-M, Mackey JR. Ocular toxicity and cancer chemotherapy. A review. Cancer. 1996;78(7):1359–1373. doi: 10.1002/(SICI)1097-0142(19961001)78:7<1359:: AID-CNCR1>3.0.CO;2-G
  17. Velez-Montoya R, Olson JL, Petrash MJ, et al. Acute Onset Central Serous Retinopathy In Association With Mek Inhibitor Use For Metastatic Cancer. Invest Ophthal Vis Sci. 2011;52:2153–2153.

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Funduscopy. There is a subretinal hemorrhage in the foveal zone, a yellow-grey rounded focus with a diameter of about 1/3 of the optic disc above the foveola

下载 (90KB)
索引源数据
3. Fig. 2. Optical coherence tomography of the right eye: neuroepithelial detachment, hyperreflective subretinal focus under the neuroepithelium (CNV type 2)

下载 (94KB)
索引源数据
4. Fig. 3. Fluorescein angiography of the central part of the retina of the right eye. Аrterio-venous phase of the study, hyperfluorescence and accumulation of dye in the zone of choroidal neovascularization

下载 (138KB)
索引源数据
5. Fig. 4. Optical coherence tomography 4 months before the appearance of choroidal neovascularization. On the slice in the parafoveal zone, a slit-like detachment of the pigment epithelium is determined, which was not present at patient previous visit

下载 (188KB)
索引源数据
6. Fig. 5. Development of choroidal neovascularization: horizontal linear OCT-scan on one of the first visits after the start of treatment with a MEK-inhibitors (a): after 15 months of treatment, the appearance of neuroepithelial detachment, hyperreflective subretinal focus — CNV (b); there is an increase in the size of the hyperreflective subretinal focus (c); the same OCT-scan on subsequent visits against the background of renewed anti-VEGF therapy, a noticeable decrease in the size of the subretinal membrane, an increase in the reflexivity and density of the focus (d, e)

下载 (189KB)
索引源数据

版权所有 © Tkachenko N., Belekhova S., Zhukova N., Prokopchuk V., Chernova N., 2022

Creative Commons License
此作品已接受知识共享署名-非商业性使用-禁止演绎 4.0国际许可协议的许可。
 


##common.cookie##