OCULAR toxicities are an emerging challenge in the management of gynecologic cancers treated with antibody drug conjugates, with new research outlining prevention and care strategies to safeguard patient outcomes. Antibody drug conjugates, including mirvetuximab soravtansine and tisotumab vedotin, have shown clinical benefit for patients with ovarian and cervical cancers who have limited therapeutic options. However, their efficacy is tempered by adverse ocular effects such as keratopathy, blurred vision, and dry eye, which can interfere with adherence and quality of life.
The review examined current evidence on the incidence, mechanisms, and clinical presentation of ocular adverse events associated with antibody drug conjugates in gynecologic oncology. Findings highlight the importance of early identification and multidisciplinary management to minimize the impact of these toxicities while maintaining therapeutic efficacy.
Practical strategies for prevention and monitoring include prophylactic topical therapies, supportive eye care, and close clinical follow up. When ocular complications occur, clinicians may implement dose adjustments, treatment interruptions, or supportive interventions to allow patients to continue therapy safely. Vaccination against herpes zoster has also been discussed as a measure to reduce risk in certain cases.
The authors emphasize that comprehensive management of ocular toxicity is essential to optimize the use of antibody drug conjugates and preserve both treatment benefit and patient wellbeing. Ongoing research is expected to refine preventive measures and further support the safe integration of these novel agents into gynecologic oncology practice.
Reference: Scandurra G et al. Management of ocular toxicity in patients with gynecologic cancer receiving novel antibody drug conjugates: a narrative review. Review Clin Transl Oncol. 2025. doi: 10.1007/s12094-025-04050-5
