Abstract
Limbal stem cell deficiency (LSCD) secondary to drug toxicity has been reported in topical and systemic chemotherapy. We report the first case of LSCD arising from a novel antibody-drug conjugate (ADC), Daptopotamab deruxtecan (Dato-DXd), in a patient with breast cancer. A 66-year-old female with treatment-naïve breast cancer was enrolled in a clinical trial with regimen of Dato-DXd in combination with Durvalumab. She suffered from blurred vision, photophobia and ocular pain of both eyes after administration of the regimen for 5 months. Slit-lamp biomicroscopy with fluorescein staining revealed irregular epithelium at the upper 1/3 cornea. There was limited effect of topical steroid and lubricants, yet significant improvement after the cessation of Dato-DXd. The cornea resumed clear, and the best-corrected visual acuity were 20/20 in both eyes 6 months after discontinuation of Dato-DXd. Early detection of the ocular adverse reaction and cessation of the causative drug can avoid permanent ocular morbidity and visual impairment.
Published Version
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