Vandetanib
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Reactions 1268 - 5 Sep 2009 ★ Vandetanib First report of corneal verticillata: case report A 48-year-old woman developed corneal verticillata during treatment with vandetanib for grade III anaplastic astrocytoma. The woman, who had a history of epithelial basement membrane dystrophy, recurrent corneal erosions and external beam radiation therapy, was enrolled in a vandetanib study in February 2006. She reported increasing ocular irritation after receiving approximately twelve cycles of vandetanib 300 mg/day, each cycle lasting 1 month. In March 2007, she presented with lacrimation, intermittent blurred vision, changes in contrast sensitivity and glare. Both eyes showed a visual acuity of 20/25 and mild meibomian gland disease. Corneal examination of both eyes showed prominent subepithelial whorls with a surrounding subepithelial haze. Left-eye changes were diffuse, with multiple fine deposits of subepithelial material. The most prominent changes were evident in her inferior right eye. The woman was prescribed carmellose, and mild symptom improvement was noted at a 3-week follow-up. She started receiving sodium chloride drops and ointment, and vandetanib was decreased to 100 mg/day. Improvement was reported over the following 2-3 months, and in October 2007, while on maintenance sodium chloride ointment and drops, she reported decreased ocular irritation and improved visual symptoms. Her visual acuity was 20/20 at a 7-month follow-up, her ophthalmic examination remained stable, and there was no evidence of new corneal erosions. Author comment: "The precise mechanism of vandetanib in the pathogenesis of corneal verticillata formation in our patient is not clear, but its anti-[epidermal growth factor receptor] action may have played a role." Yeh S, et al. Corneal verticillata after dual anti-epidermal growth factor receptor and anti-vascular endothelial growth factor receptor 2 therapy (vandetanib) for anaplastic astrocytoma. Cornea 28: 699-702, No. 6, Jul 2009 - USA 801150242 » Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of corneal verticillata associated with vandetanib. The WHO ADR database did not contain any reports of keratopathy associated with vandetanib. 1 Reactions 5 Sep 2009 No. 1268 0114-9954/10/1268-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Vandetanib
Reactions 1268 - 5 Sep 2009
★Vandetanib
First report of corneal verticillata: case reportA 48-year-old woman developed corneal verticillata
during treatment with vandetanib for grade III anaplasticastrocytoma.
The woman, who had a history of epithelial basementmembrane dystrophy, recurrent corneal erosions andexternal beam radiation therapy, was enrolled in avandetanib study in February 2006. She reportedincreasing ocular irritation after receiving approximatelytwelve cycles of vandetanib 300 mg/day, each cycle lasting1 month. In March 2007, she presented with lacrimation,intermittent blurred vision, changes in contrast sensitivityand glare. Both eyes showed a visual acuity of 20/25 andmild meibomian gland disease. Corneal examination ofboth eyes showed prominent subepithelial whorls with asurrounding subepithelial haze. Left-eye changes werediffuse, with multiple fine deposits of subepithelialmaterial. The most prominent changes were evident in herinferior right eye.
The woman was prescribed carmellose, and mildsymptom improvement was noted at a 3-week follow-up.She started receiving sodium chloride drops and ointment,and vandetanib was decreased to 100 mg/day.Improvement was reported over the following 2-3 months,and in October 2007, while on maintenance sodiumchloride ointment and drops, she reported decreasedocular irritation and improved visual symptoms. Her visualacuity was 20/20 at a 7-month follow-up, her ophthalmicexamination remained stable, and there was no evidence ofnew corneal erosions.
Author comment: "The precise mechanism of vandetanibin the pathogenesis of corneal verticillata formation in ourpatient is not clear, but its anti-[epidermal growth factorreceptor] action may have played a role."Yeh S, et al. Corneal verticillata after dual anti-epidermal growth factor receptorand anti-vascular endothelial growth factor receptor 2 therapy (vandetanib) foranaplastic astrocytoma. Cornea 28: 699-702, No. 6, Jul 2009 - USA 801150242
» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of cornealverticillata associated with vandetanib. The WHO ADRdatabase did not contain any reports of keratopathyassociated with vandetanib.
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Reactions 5 Sep 2009 No. 12680114-9954/10/1268-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
