Article ; Online: Epidermal Growth Factor Receptor Inhibitors for Lung Cancer and the Risk of Keratitis.
2024 Volume 142, Issue 2, Page(s) 140–145
Abstract: Importance: Epidermal growth factor receptor inhibitors (EGFRis) have been reported to be associated with cutaneous and ocular side effects; however, there is limited evidence of an association between EGFRi treatment and keratitis.: Objective: To ... ...
| Abstract | Importance: Epidermal growth factor receptor inhibitors (EGFRis) have been reported to be associated with cutaneous and ocular side effects; however, there is limited evidence of an association between EGFRi treatment and keratitis. Objective: To determine the association between EGFRi treatment and agents and the risk of new-onset keratitis among patients with lung cancer. Design, setting, and participants: This US population-based cohort study examined TriNetX data of patients with lung cancer treated with or without EGFRis between May 1, 2003, and October 30, 2023. Exposures: Treatment with EGFRis, including the first-generation agents gefitinib and erlotinib, the second-generation agent afatinib, and the third-generation agent osimertinib. Main outcomes and measures: The risk of new-onset keratitis among patients with lung cancer receiving EGFRi treatment was determined using logistic and Cox proportional hazards regression. Results: Among 1 388 108 patients with lung cancer, 22 225 received EGFRis (mean [SD] age, 69.7 [10.6] years; 62.8% females and 37.2% males). Patients treated with EGFRis had a higher risk of keratitis than nonexposed patients (hazard ratio [HR], 1.520; 95% CI, 1.339-1.725). Subtypes of EGFRi-associated keratitis included keratoconjunctivitis (HR, 1.367; 95% CI, 1.158-1.615), superficial keratitis (HR, 1.635; 95% CI, 1.306-2.047), and corneal ulcer (HR, 2.132; 95% CI, 1.515-3.002). Patients taking afatinib had a higher risk of keratitis (HR, 2.229; 95% CI, 1.480-3.356). Conclusions and relevance: These findings suggest that patients with lung cancer treated with EGFRis may have an increased risk of new-onset keratitis, especially with the second-generation EGFRi afatinib, supporting the need for prompt diagnosis and management of EGFRi-associated ocular issues to prevent serious complications or treatment disruptions. |
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| MeSH term(s) | Male ; Female ; Humans ; Aged ; Lung Neoplasms/drug therapy ; Afatinib/adverse effects ; Cohort Studies ; ErbB Receptors/genetics ; ErbB Receptors/therapeutic use ; Keratitis/chemically induced ; Keratitis/diagnosis ; Keratitis/epidemiology ; Protein Kinase Inhibitors/adverse effects ; Mutation |
| Chemical Substances | Afatinib (41UD74L59M) ; ErbB Receptors (EC 2.7.10.1) ; Protein Kinase Inhibitors |
| Language | English |
| Publishing date | 2024-01-11 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2701705-9 |
| ISSN | 2168-6173 ; 2168-6165 |
| ISSN (online) | 2168-6173 |
| ISSN | 2168-6165 |
| DOI | 10.1001/jamaophthalmol.2023.6089 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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