Purpose: Trifluridine/tipiracil hydrochloride combination tablet (FTD/TPI) is an oral antitumor drug, approved in Japan in 2014. Here we report a case of corneal dysfunction caused by FTD/TPI.
Case: A 56-year-old female with sigmoid colon cancer with multiple metastases underwent postoperative chemotherapy over 11 months. Despite this, the tumor continued to spread and three courses of oral administration FTD/TPI were implemented. She was referred to our department due to foreign body sensation and hyperemia, which she had become aware of since prior to initiating the fourth course. Visual acuity was 20/20 (n.c.) in the right eye and (20/20×-1.00 D) in the left eye. Bilateral conjunctival hyperemia was observed with abnormal epithelial invasion of nearly the entire circumference. A portion of the abnormal epithelium, which was bilaterally invaded in the cornea, was positive on fluorescein staining, and there was also a corneal ulcer above the right eye. We initiated bilateral treatment with 0.3% gatifloxacin and 0.1% betamethasone eye-drops, four times daily. FTD/TPI was immediately discontinued due to anemia with fever and epigastric pain, and the conjunctival invasion, hyperemia, and corneal ulcer improved within 1 week after presenting at our department. Since then, there has been no recurrence of conjunctival hyperemia and corneal ulcer with the change of antitumor drug, and her visual acuity was 20/20 (n.c.) in the right eye and (20/20×-1.00 D) in the left eye. The patient's treatment has progressed successfully without visual impairment.
Conclusion: FTD/TPI may cause bilateral corneal epithelial damage.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 129-135, 2021.