Antibody-Drug Conjugates and Ocular Toxicity: Nursing, Patient, and Organizational Implications for Care.

Abstract

Antibody-drug conjugates (ADCs) are a novel class of drugs with rapidly expanding oncology indications across solid and hematologic malignancies. This article provides an overview of ADCs with a high risk of ocular reactions and guidance for oncology nurses to help mitigate risk and identify toxicities for prompt management. This review presents updated evidence, manufacturer recommendations, and clinical guidance about three ADCs with a risk of overall ocular reactions exceeding 40%, as well as strategies to prepare patients for treatment, prevent reactions, and respond to presenting ocular toxicities. ADCs can cause a range of ocular reactions from mild dry eye to severe and dose- limiting corneal adverse reactions and vision loss. Oncology nurses and other members of the interprofessional team can perform focused clinical assessment, provide patient education about self-management and prevention, and coordinate surrounding eye care for patients receiving treatment with ADCs.