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Blenrep Causes Eye Damage?
According to the research linked below Blenrep causes eye damage. Sometimes it is permanent eye damage. And the side effect doesn’t appear to be well understood by oncology.
When myeloma patients hear their oncologist talking about an immunotherapy, the patient may think that their therapy doesn’t bring the side effects of “chemotherapy.” And they don’t bring the same side effects necessarily. But they can bring side effects.
What are some side effects of blenrep for myeloma patients?
Common side effects include:
1. Ocular Toxicity
Ocular side effects are among the most common and potentially serious issues with Blenrep:
- Keratopathy: Changes in the corneal epithelium, often detected during eye exams.
- Vision Changes: Blurred vision, dry eyes, or decreased visual acuity.
- Dry Eye Syndrome: Requires regular use of lubricating eye drops.
- Photophobia: Sensitivity to light.
Patients are often required to undergo regular eye exams before and during treatment to monitor these effects.
2. Hematologic Side Effects
- Thrombocytopenia: A decrease in platelet count, which can increase the risk of bleeding.
- Anemia: Low red blood cell counts, potentially leading to fatigue or shortness of breath.
- Neutropenia: Reduced white blood cell count, which may increase infection risk.
3. Infusion-Related Reactions
These may occur during or after the drug infusion:
- Fever
- Chills
- Nausea
- Hypotension or hypertension
- Dyspnea (difficulty breathing)
4. Gastrointestinal Symptoms
- Nausea
- Diarrhea or constipation
- Decreased appetite
- Vomiting
5. General Side Effects
- Fatigue
- Pyrexia (fever)
- Peripheral edema (swelling, usually in the legs or arms)
- Back pain or musculoskeletal pain
6. Hepatic Side Effects
- Elevated liver enzymes, such as aspartate aminotransferase (AST) or alanine aminotransferase (ALT).
Watch Sagar Lonial, MD, minimize the importance of ocular toxicity of Blenrep-
Living with MM as well as serious, permanent side effects since my conventional treatments in 1994, I have watched conventional oncology minimize the importance of side effects. NDMM patients beware.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about managing MM and possible side effects.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Eye Toxicities Are a Growing Concern With Certain ADCs
“Despite being a targeted therapy, antibody-drug conjugates (ADCs) can cause significant off-target toxicity to the eyes of patients being treated for advanced multiple myeloma or cervical cancer, yet the risks remain relatively unknown, according to oncologists and ophthalmologists…
Ocular Toxicities Seen on Ocular Surface
Ocular toxicities with these drugs are “not necessarily a new thing…”
“But what we’re seeing with certain ADCs is a lot of ocular toxicity, especially on the ocular surface,” with the degree toxicity varying depending on the ADC in question. “It’s definitely a real concern…”
In addition, the drug may, once it is in the tumor cells, be metabolized to an active metabolite that could, again, result in systemic exposure…
Side Effects Are Underappreciated and Distressing
Ocular toxicity remains underappreciated among oncologists prescribing these drugs. One reason is that it “did not get enough attention” in the initial clinical trial reports, Miller said she suspects.
Another potential reason for this is that “we’re not used to thinking about it because it’s not particularly common among the drugs that oncologists use frequently,” she added. Additionally, it tends to come up later during treatment, “so people have to be on therapy for some time before you start to see it.”
Nevertheless, Miller underlined that ocular toxicity “can be particularly distressing for patients, as it’s uncomfortable [and] can lead to scarring, so some of the vision issues can be permanent…”
“Corneal damage is pretty common, and patients can present with blurry vision, or dry eyes, or light sensitivity. And unlike some side effects, these are things that really impact people at every waking moment of their day.”
“So they’re pretty clinically significant side effects, even if they’re not life-threatening,” Meisel emphasized.
Miller suspects that more heavily pretreated patients may be more likely to experience ocular toxicity, as “there’s a much higher incidence of dry eyes in our patients than we recognize…”
However, she noted that steroids have not been found to be useful in patients given belantamab, so clinicians have tried vasoconstrictor eye drops immediately prior to the infusion, as well as ocular cooling masks, which “are thought to help by reducing blood supply to the ocular areas.”
Other approaches to minimize ocular toxicity have included longer infusion times, so it’s “not so much of a hefty dose at one time,” Kang added.
She underlined that grade 2 and 3 ocular toxicities can lead to dose delays or dose modifications, and “usually by the time you get a grade 4 event, then you may need to discontinue the medication…”
Closer Collaboration Between Specialists Needed
What’s known about ocular side effects in patients taking ADCs underlines that there is a need for closer collaboration between oncologists and ophthalmologists.
“In oncology, especially as immunotherapies came to the forefront, our relationships with our endocrinology colleagues have become stronger because we’ve needed them to help us manage things like thyroid toxicity and pituitary issues related to immunotherapy,” Meisel said…
The oncologist “not only needs to be aware” of and looking for ocular toxicity when using these ADCs but also needs to be thinking: “If I run into trouble here, who’s my ophthalmology backup? Are they familiar with this drug? And do we have a plan for the multispecialty management of patients who run into this toxicity?”
Blenrep causes eye damage Blenrep causes eye damage