Taxane-based chemo poses risk of ocular adverse events

Women who use taxane chemotherapy agents are likely to experience epiphora, cystoid macular edema (CME), and optic neuropathy, as reported in a retrospective cohort study.

Researchers used data from a private health-claims database from the US and reviewed the medical records of new users of women with breast cancer who were taking taxane-based chemotherapy (docetaxel or paclitaxel) and new users of tamoxifen (controls). They quantified the risk of three mutually exclusive ocular adverse events, namely epiphora, CME, and optic neuropathy.

A total of 18,219 patients were included in the epiphora analysis and optic neuropathy analysis, among whom 1,824 were taxane users (mean age 62.1 years) and 16,395 were tamoxifen users (mean age 54.6 years).

Compared with tamoxifen, taxane-based chemotherapy was associated with an elevated risk of epiphora was (adjusted hazard ratio [HR], 5.15, 95 percent confidence interval [CI], 2.79–9.54) and optic neuropathy (adjusted HR, 4.44, 95 percent CI, 1.04–18.87).

Meanwhile, 18,433 users were included in the CME analysis, of whom 1,909 were taxane users (mean age 62.5 years) and 16,524 were tamoxifen users (mean age 54.6 years). Likewise, taxane-based chemotherapy use was a risk factor for CME (adjusted HR, 1.33, 95 percent CI, 0.70–2.53).

The risk estimates for epiphora and CME in the taxane cohort during the time of exposure compared with the period prior to use of the drugs were also elevated (HR, 2.86, 95 percent CI, 1.11–7.39 and HR, 2.27, 95 percent CI, 0.68–7.54, respectively).

In light of the findings, ophthalmologists and oncologists should be aware of the observed ocular adverse events in women with breast cancer who receive taxane-based chemotherapy.