Variability in Prophylactic Strategies and Use of Supportive Care Across ADCs

In this segment, the expert faculty reviews how prophylactic and supportive care measures differ among antibody–drug conjugates (ADCs) with ocular toxicity risks, emphasizing the impact of these requirements on patients. The panel notes that preservative-free artificial tears are universally recommended and form the foundation of ocular supportive care across ADC classes. They explain that steroid eye drops are required only for certain gynecologic ADCs—specifically mirvetuximab soravtansine and tisotumab vedotin—because their toxicity patterns respond to steroid prophylaxis. Expert faculty also highlights the risks of steroid use, including steroid-induced glaucoma and accelerated cataract formation, underscoring the importance of baseline ophthalmologic evaluation to determine individual vulnerability.

The faculty further discusses infusion-day measures such as cold compresses and vasoconstrictor eye drops, as well as practical considerations like spacing steroid and lubricating drops to avoid dilution. They stress that most ADC-related corneal changes are noninflammatory, explaining why steroids show limited benefit outside the gynecologic agents. The conversation closes with reminders about contact lens avoidance and the need for clear patient education materials to support adherence and mitigate complications.