Taxane-based chemotherapy may increase risk of ocular adverse effects

The taxane-based chemotherapy agents, docetaxel and paclitaxel, are used to treat a variety of cancers. About 60% of women with breast cancer are diagnosed with invasive breast cancer, which usually requires chemotherapy that includes paclitaxel or docetaxel. The ocular adverse effects of taxanes have not been well studied. To examine this issue, Canadian investigators conducted a large pharmacoepidemiologic study to quantify the risk of three mutually exclusive ocular adverse events with taxane-based chemotherapy: epiphora, cystoid macular edema and optic neuropathy. Epiphora, a significantly debilitating condition, may be irreversible and greatly reduce quality of life, particularly outdoor activities. If treatable, correction of epiphora can significantly improve overall health and quality of life. Cystoid macular edema and optic neuropathy are also serious adverse events that can considerably decrease vision and quality of life. Prompt diagnosis and treatment can improve patient outcomes. Read: Latest drug indications: key updates for June/July The retrospective cohort study used data from a private US health-claims database that includes health information for more than 150 million patients. The study team created a cohort of new users of women with cancer who were taking taxane-based chemotherapy (docetaxel or paclitaxel). New users of tamoxifen served as the control group. The main results are summarized below: Epiphora: The analysis included 1,824 taxane users (paclitaxel or docetaxel) and 16,395 tamoxifen users (controls). The incidence of epiphora among taxane users was 55.6/10,000 person-years vs 7.9/10,000 person-years for tamoxifen users. The adjusted hazard ratio (HR) for this association was 5.15 (95% confidence interval [CI], 2.79–9.54). Cystoid macular edema: The analysis included 1,909 taxane users and 16,524 tamoxifen users (controls). The incidence of cystoid macular edema among taxane users was 34.8/10,000 person-years vs 16.8/10000 person-years for tamoxifen users (controls). The adjusted HR was 1.33 (95% CI, 0.70–2.53). Optic neuropathy: The analysis included 1,913 taxane users and 16,566 tamoxifen users (controls). The incidence of optic neuropathy for taxane users was 10.6/10,000 person-years and 1.2/10 000 person-years for tamoxifen users (controls). The adjusted HR was 4.44 (95% CI, 1.04–18.87). The authors conclude that women using taxane chemotherapy (paclitaxel or docetaxel) are at increased risk for the ocular adverse effects of epiphora, cystoid macular edema and optic neuropathy. Ophthalmologists, oncologists and other healthcare providers should be aware of the possibility of these adverse events in women with cancer who receive these drugs. Early identification of these adverse effects may aid in treatment of complications and lead to better patient outcomes and quality of life. Reference 1. Sodhi M, Yeung SN, Maberley D, et al. Risk of ocular adverse events with taxane-based chemotherapy. JAMA Ophthalmol 2022; Published online August 11, 2022. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2795314#:~:text=Conclusion-,In%20a%20cohort%20of%20women%20who%20were%20using%20taxane%20chemotherapy,span%20from%200.70%20to%202.53) (accessed August 16, 2022).

Taxane-based chemotherapy may increase risk of ocular adverse effects

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