Ophthalmologic toxicities of novel anticancer therapies

New anticancer strategies increasingly rely on targeted therapies, which maximize anticancer activity while reducing toxicity to healthy cells. These modern anticancer therapies (MATs) mainly include immune checkpoint inhibitors (ICIs), antibody drug conjugates (ADCs) and targeted anticancer therapies (TATs) which inhibit signal transduction pathways. These new molecules are associated with a wide range of ocular adverse events (OAEs), of varying severity: from ocular surface irritation to irreversible vision loss. ICIs can trigger autoimmune responses in all eye tissues. ADCs mainly cause ocular surface toxicity, the most specific of which being microcyst-like epithelial changes (MECs). TATs cause a wide range of OAEs, depending on their class. Oncologists and ophthalmologists will be increasingly confronted to these OAEs – some of which are still poorly characterized – as the number of prescribed NTAs increases. Close collaboration between specialists is essential for their early identification and management, which helps reduce visual and quality of life consequences for these patients. This review addresses the clinical characteristics of the main OAEs linked to MATs, the description of the suspected underlying pathophysiological mechanisms and the key points of their management.