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New research · Ophthalmology
American journal of ophthalmology · 18h
StudyAmerican journal of ophthalmology · 2026

Clinical Features of Corneal Adverse Events Associated With Trastuzumab Botidotin: Payload-Driven Epitheliopathy and Neuropathy.

Yongyi Zhang, Gege Tang, Jingjie Zhang … Nan Zhou
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OphthalmologyStudy

Trastuzumab botidotin caused severe eye-surface symptoms to develop in all treated patients.

Clinical Features of Corneal Adverse Events Associated With Trastuzumab Botidotin: Payload-Driven Epitheliopathy and Neuropathy.

Yongyi Zhang … Nan Zhou
American journal of ophthalmology · 2026
Background

HER2-targeted antibody-drug conjugates (antibody-drug conjugates) demonstrate significant efficacy in HER2-mutated or HER2-positive tumors but may cause ocular adverse events (adverse events), particularly corneal epitheliopathy and blurred vision.

Purpose

This study aimed to characterize the clinical features of trastuzumab botidotin (a HER2-targeted antibody-drug conjugates)-related corneal adverse events.

Methods

SUBJECTS: Eight adult patients (15 eyes) with HER2-mutated or HER2-positive solid tumors treated with trastuzumab botidotin.

n = 15 eyes
Results
65.10
± 13.26
eye-surface symptom severity score rose sharply, showing much worse eye discomfort
n = 15 eyes
More results

Corneal adverse events occurred in all eight patients.

The mean time to visual impairment onset was 37.25 ± 5.90 days after trastuzumab botidotin initiation, with symptom severity peaking at 82.75 ± 14.26 days.

More results

Trastuzumab botidotin caused dry eye in all patients (n = 8), resulting in reduced Schirmer's test results (from 8.94 ± 1.66 mm to 4.20 ± 1.58 mm), shortened tear break-up time (from 9.63 ± 1.21 seconds to 3.37 ± 1.61 seconds), and decreased tear meniscus height (from 0.23 ± 0.04 mm to 0.14 ± 0.02 mm).

“
Conclusion · 1 of 2

Trastuzumab botidotin was associated with visual impairment, corneal epitheliopathy, and nerve damage.

Conclusion · 2 of 2

Close collaboration between ophthalmologists and oncologists is crucial for early detection of corneal adverse events related to antibody-drug conjugates therapy, thereby improving clinical outcomes and patient quality of life.

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