Abstract
During breast cancer therapy, paclitaxel and trastuzumab are both associated with adverse effects such as chemotherapy-induced peripheral neuropathy and other systemic side effects including ocular complications. Corneal nerves are considered part of the peripheral nervous system and can be imaged non-invasively by confocal laser scanning microscopy (CLSM) on the cellular level. Thus, in vivo CLSM imaging of structures of the corneal subbasal nerve plexus (SNP) such as sensory nerves or dendritic cells (DCs) can be a powerful tool for the assessment of corneal complications during cancer treatment. During the present study, the SNP of a breast cancer patient was analyzed over time by using large-scale in vivo CLSM in the course of paclitaxel and trastuzumab therapy. The same corneal regions could be re-identified over time. While the subbasal nerve morphology did not alter significantly, a change in dendritic cell density and an additional local burst within the first 11 weeks of therapy was detected, indicating treatment-mediated corneal inflammatory processes. Ocular structures such as nerves and dendritic cells could represent useful biomarkers for the assessment of ocular adverse effects during cancer therapy and their management, leading to a better visual prognosis.
Highlights
Cancer is the leading cause of death in the developed world, and besides the traditional non-surgical treatments, including radiation and chemotherapeutic drugs, the current trend is focused on using targeted biological therapies eliminating cancer cells only or interfering with tumor growth and progression by specific molecules or antibodies [1,2]
The results of [8,22,28] support the findings presented here regarding the distribution and morphology of dendritic cells (DCs) in the patient’s subbasal nerve plexus (SNP), indicating treatment-mediated local inflammatory response in the cornea
The large-scale in vivo confocal laser scanning microscopy (CLSM) technique used enabled the longitudinal detection of the SNP of a patient in the course of the treatment regimen
Summary
Cancer is the leading cause of death in the developed world, and besides the traditional non-surgical treatments, including radiation and chemotherapeutic drugs, the current trend is focused on using targeted biological therapies eliminating cancer cells only or interfering with tumor growth and progression by specific molecules or antibodies [1,2]. Ferdousi et al reported small fiber neuropathy of corneal nerve plexus detected by in vivo confocal laser scanning microscopy (CLSM) in patients with upper gastrointestinal cancer and treatment with platinum-based chemotherapy [4]. Corneal changes detected by in vivo CLSM were found in breast cancer patients treated with trastuzumab [6,7,8].
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