Ocular Toxicities Across Breast, Lung, and Gynecologic ADCs: Incidence, Management, and Clinical Implications

In this segment, the expert faculty reviews ocular toxicities associated with antibody–drug conjugates (ADCs) across breast, lung, and gynecologic oncology. They begin with an overview of datopotamab deruxtecan, the primary breast cancer ADC linked to ocular events. The panel notes that most cases are mild—primarily dry eye—with low rates of keratitis and rare grade ≥3 toxicities, typically manageable with preservative-free artificial tears and occasional dose adjustments.

The discussion expands to the lung cancer setting, where telisotuzumab vedotin and datopotamab deruxtecan demonstrate similarly low-grade ocular toxicities, often controlled with lubricating drops, though ophthalmology involvement remains essential to rule out more serious pathology.

In the gynecologic space, the faculty highlights the rapid expansion of ADC development and emphasizes that despite initial concerns, ocular events are generally low-grade and reversible when managed appropriately. They stress that familiarity with toxicity patterns, adherence to supportive care protocols, and effective communication with eye specialists are critical to ensuring patients receive the full therapeutic benefit of these highly active agents.