Pan fibroblast growth factor receptor inhibitor associated retinopathy

Abstract

Purpose

To report a case of Fibroblast Growth Factor Receptor inhibitor (FGFRi) associated retinopathy in a patient treated with Erdafitinib.

Case report

A patient with a history of non-muscle invasive urothelial carcinoma treated with Erdafitinib developed symptomatic unifocal bilateral serous retinal detachments (SRD) eight weeks after starting this new treatment. Six months after discontinuing the drug, the SRDs resolved and visual acuity recovered to baseline. However, hyper and hypo auto fluorescent lesions were still visible on fundus autofluorescence, suggesting a still ongoing retinal pigment epithelium (RPE) impairment.

Conclusions

Cancer treatments using FGFRi are showing promising results but their ocular toxicity is not well reported nor fully understood. Oncologists should be aware of the potential risks associated with FGFRi and involve ophthalmologists for the follow-up of their patients. The toxicity of FGFRi seems to resolve after drug continuation, but a certain degree of infra clinical RPE impairment may persist. Longer term follow-ups are warranted to further understand the effects of FGFRi on the RPE.

Keywords

Erdafitinib FGFR inhibitor fibroblast growth factor receptor inhibitor associated retinopathy ocular toxicity serous retinal detachment side effects

Get full access to this article

View all access options for this article.

References

Montazeri

Bellmunt

. Erdafitinib for the treatment of metastatic bladder cancer. Expert Rev Clin Pharmacol 2020; 13: 1–6.

van der Noll

Leijen

Neuteboom

, et al. Effect of inhibition of the FGFR-MAPK signaling pathway on the development of ocular toxicities. Cancer Treat Rev 2013; 39: 664–672.

Fasolino

Moschetta

De Grève

, et al. Choroidal and choriocapillaris morphology in Pan-FGFR inhibitor-associated retinopathy: a case report. Diagnostics (Basel) 2022; 12: 249.

Parikh

Eliott

Kim

. Fibroblast growth factor receptor inhibitor-associated retinopathy. JAMA Ophthalmol 2020; 138: 1101–1103.

Francis

Harding

Schram

, et al. Clinical and morphologic characteristics of fibroblast growth factor receptor inhibitor-associated retinopathy. JAMA Ophthalmol 2021; 139: 1126–1130.

Méndez-Martínez

Calvo

Ruiz-Moreno

, et al. Ocular adverse events associated with MEK inhibitors. Retina 2019; 39: 1435–1450.

O'Driscoll

O'Connor

O'Brien

, et al. Basic fibroblast growth factor-induced protection from light damage in the mouse retina in vivo. J Neurochem 2008; 105: 524–536.

Francis

Habib

Abramson

, et al. Clinical and morphologic characteristics of MEK inhibitor-associated retinopathy: differences from central serous chorioretinopathy. Ophthalmology 2017; 124: 1788–1798.

Ramtohul

Denis

Comet

. Pseudovitelliform maculopathy associated with FGFR inhibitor therapy. Ophthalmol Retina 2021; 5: 140.

10.

Tyagi

Santiago

. New features in MEK retinopathy. BMC Ophthalmol 2018; 18: 221.

11.

United States Food and Drug Administration. BALVERSA (erdafitinib) tablets, for oral use. Highlights of prescribing information, www.accessdata.fda.gov/drugsatfda_docs/label/2023/212018s005lbl.pdf (2019, accessed 27 July 2023).

12.

Mahipal

Tella

Kommalapati

, et al. Prevention and treatment of FGFR inhibitor-associated toxicities. Crit Rev Oncol Hematol 2020; 155: 103091.

13.

National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v5.0, https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf (2017, accessed 27 July 2023).