Rapid Onset of Retinal Toxicity From High-Dose Hydroxychloroquine Given for Cancer Therapy.
Identifieur interne : 000242 ( PubMed/Corpus ); précédent : 000241; suivant : 000243Rapid Onset of Retinal Toxicity From High-Dose Hydroxychloroquine Given for Cancer Therapy.
Auteurs : Loh-Shan B. Leung ; Joel W. Neal ; Heather A. Wakelee ; Lecia V. Sequist ; Michael F. MarmorSource :
- American journal of ophthalmology [ 1879-1891 ] ; 2015.
English descriptors
- KwdEn :
- Aged, Antineoplastic Agents (therapeutic use), Antirheumatic Agents (administration & dosage), Antirheumatic Agents (adverse effects), Carcinoma, Non-Small-Cell Lung (drug therapy), Drug Therapy, Combination, Electroretinography, Erlotinib Hydrochloride (therapeutic use), Female, Fluorescein Angiography, Humans, Hydroxychloroquine (administration & dosage), Hydroxychloroquine (adverse effects), Lung Neoplasms (drug therapy), Male, Middle Aged, Retina (drug effects), Retina (pathology), Retinal Diseases (chemically induced), Retinal Diseases (diagnosis), Retrospective Studies, Tomography, Optical Coherence, Visual Field Tests, Visual Fields.
- MESH :
- chemical , administration & dosage : Antirheumatic Agents, Hydroxychloroquine.
- chemical , adverse effects : Antirheumatic Agents, Hydroxychloroquine.
- chemical , therapeutic use : Antineoplastic Agents, Erlotinib Hydrochloride.
- chemically induced : Retinal Diseases.
- diagnosis : Retinal Diseases.
- drug effects : Retina.
- drug therapy : Carcinoma, Non-Small-Cell Lung, Lung Neoplasms.
- pathology : Retina.
- Aged, Drug Therapy, Combination, Electroretinography, Female, Fluorescein Angiography, Humans, Male, Middle Aged, Retrospective Studies, Tomography, Optical Coherence, Visual Field Tests, Visual Fields.
Abstract
To report rapid onset of retinal toxicity in a series of patients followed on high-dose (1000 mg daily) hydroxychloroquine during an oncologic clinical trial studying hydroxychloroquine with erlotinib for non-small cell lung cancer.
DOI: 10.1016/j.ajo.2015.07.012
PubMed: 26189086
Links to Exploration step
pubmed:26189086Le document en format XML
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<author><name sortKey="Leung, Loh Shan B" sort="Leung, Loh Shan B" uniqKey="Leung L" first="Loh-Shan B" last="Leung">Loh-Shan B. Leung</name>
<affiliation><nlm:affiliation>Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California. Electronic address: lbleung@stanford.edu.</nlm:affiliation>
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<author><name sortKey="Neal, Joel W" sort="Neal, Joel W" uniqKey="Neal J" first="Joel W" last="Neal">Joel W. Neal</name>
<affiliation><nlm:affiliation>Department of Medicine, Division of Oncology, Stanford University/Stanford Cancer Institute, Palo Alto, California.</nlm:affiliation>
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<author><name sortKey="Wakelee, Heather A" sort="Wakelee, Heather A" uniqKey="Wakelee H" first="Heather A" last="Wakelee">Heather A. Wakelee</name>
<affiliation><nlm:affiliation>Department of Medicine, Division of Oncology, Stanford University/Stanford Cancer Institute, Palo Alto, California.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Sequist, Lecia V" sort="Sequist, Lecia V" uniqKey="Sequist L" first="Lecia V" last="Sequist">Lecia V. Sequist</name>
<affiliation><nlm:affiliation>Department of Medicine, Division of Hematology/Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.</nlm:affiliation>
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<term>Carcinoma, Non-Small-Cell Lung (drug therapy)</term>
<term>Drug Therapy, Combination</term>
<term>Electroretinography</term>
<term>Erlotinib Hydrochloride (therapeutic use)</term>
<term>Female</term>
<term>Fluorescein Angiography</term>
<term>Humans</term>
<term>Hydroxychloroquine (administration & dosage)</term>
<term>Hydroxychloroquine (adverse effects)</term>
<term>Lung Neoplasms (drug therapy)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retina (drug effects)</term>
<term>Retina (pathology)</term>
<term>Retinal Diseases (chemically induced)</term>
<term>Retinal Diseases (diagnosis)</term>
<term>Retrospective Studies</term>
<term>Tomography, Optical Coherence</term>
<term>Visual Field Tests</term>
<term>Visual Fields</term>
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<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antirheumatic Agents</term>
<term>Hydroxychloroquine</term>
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<term>Hydroxychloroquine</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antineoplastic Agents</term>
<term>Erlotinib Hydrochloride</term>
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<keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Retinal Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Retinal Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Retina</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Carcinoma, Non-Small-Cell Lung</term>
<term>Lung Neoplasms</term>
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</keywords>
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<term>Drug Therapy, Combination</term>
<term>Electroretinography</term>
<term>Female</term>
<term>Fluorescein Angiography</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Tomography, Optical Coherence</term>
<term>Visual Field Tests</term>
<term>Visual Fields</term>
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<front><div type="abstract" xml:lang="en">To report rapid onset of retinal toxicity in a series of patients followed on high-dose (1000 mg daily) hydroxychloroquine during an oncologic clinical trial studying hydroxychloroquine with erlotinib for non-small cell lung cancer.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26189086</PMID>
<DateCompleted><Year>2015</Year>
<Month>12</Month>
<Day>08</Day>
</DateCompleted>
<DateRevised><Year>2015</Year>
<Month>09</Month>
<Day>14</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1891</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>160</Volume>
<Issue>4</Issue>
<PubDate><Year>2015</Year>
<Month>Oct</Month>
</PubDate>
</JournalIssue>
<Title>American journal of ophthalmology</Title>
<ISOAbbreviation>Am. J. Ophthalmol.</ISOAbbreviation>
</Journal>
<ArticleTitle>Rapid Onset of Retinal Toxicity From High-Dose Hydroxychloroquine Given for Cancer Therapy.</ArticleTitle>
<Pagination><MedlinePgn>799-805.e1</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ajo.2015.07.012</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0002-9394(15)00419-5</ELocationID>
<Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">To report rapid onset of retinal toxicity in a series of patients followed on high-dose (1000 mg daily) hydroxychloroquine during an oncologic clinical trial studying hydroxychloroquine with erlotinib for non-small cell lung cancer.</AbstractText>
<AbstractText Label="DESIGN" NlmCategory="METHODS">Retrospective observational case series.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Ophthalmic surveillance was performed on patients in a multicenter clinical trial testing high-dose (1000 mg daily) hydroxychloroquine for advanced non-small cell lung cancer. The US Food & Drug Administration-recommended screening protocol included only visual acuity testing, dilated fundus examination, Amsler grid testing, and color vision testing. In patients seen at Stanford, additional sensitive screening procedures were added at the discretion of the retinal physician: high-resolution spectral-domain optical coherence tomography (OCT), fundus autofluorescence (FAF) imaging, Humphrey visual field (HVF) testing, and multifocal electroretinography (mfERG).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Out of the 7 patients having exposure of at least 6 months, 2 developed retinal toxicity (at 11 and 17 months of exposure). Damage was identified by OCT imaging, mfERG testing, and, in 1 case, visual field testing. Fundus autofluorescence imaging remained normal. Neither patient had symptomatic visual acuity loss.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">These cases show that high doses of hydroxychloroquine can initiate the development of retinal toxicity within 1-2 years. Although synergy with erlotinib is theoretically possible, there are no prior reports of erlotinib-associated retinal toxicity despite over a decade of use in oncology. These results also suggest that sensitive retinal screening tests should be added to ongoing and future clinical trials involving high-dose hydroxychloroquine to improve safety monitoring and preservation of vision.</AbstractText>
<CopyrightInformation>Published by Elsevier Inc.</CopyrightInformation>
</Abstract>
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<ForeName>Loh-Shan B</ForeName>
<Initials>LS</Initials>
<AffiliationInfo><Affiliation>Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California. Electronic address: lbleung@stanford.edu.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Neal</LastName>
<ForeName>Joel W</ForeName>
<Initials>JW</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Division of Oncology, Stanford University/Stanford Cancer Institute, Palo Alto, California.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wakelee</LastName>
<ForeName>Heather A</ForeName>
<Initials>HA</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Division of Oncology, Stanford University/Stanford Cancer Institute, Palo Alto, California.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sequist</LastName>
<ForeName>Lecia V</ForeName>
<Initials>LV</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Division of Hematology/Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marmor</LastName>
<ForeName>Michael F</ForeName>
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<AffiliationInfo><Affiliation>Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California.</Affiliation>
</AffiliationInfo>
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