Ocular surface disease related to tisotumab vedotin-tftv

Introduction: To report a series of patients who developed ocular surface disease related to tisotumab vedotin-tftv (TV), an antibody-drug conjugate (ADC) approved for the treatment of recurrent or metastatic cervical cancer. Methods: This was a multicenter retrospective chart review study of patients who developed ocular surface disease related to TV between April 1st, 2022 to August 31st, 2023. Results: Five patients were identified who developed ocular surface disease while on TV. All patients received a standard ocular adverse event prophylaxis regimen with each infusion per the product label, including a cool ocular compress, topical vasoconstrictor, topical steroid, and artificial tears. All five patients developed conjunctival subepithelial fibrosis. Two patients developed bilateral pseudomembranous conjunctivitis, one of whom subsequently developed conjunctival scarring. Two patients developed a bilateral culture positive conjunctivitis, which responded to topical antibiotics. One patient developed bilateral infectious keratitis and was treated with partial thickness corneal transplantation of both eyes. Conclusion: TV can be associated with ocular surface disease, including conjunctival scarring and infectious keratitis. Some cases may require surgical intervention. Oncologists and ophthalmologists should be aware of the possibility of these ocular complications, especially as more ADCs are approved. Further studies are required to determine toxicity mechanisms as well as optimal prophylaxis and management strategies.