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Chemotherapy-related Skin Toxicity / Colorectal Cancer Treatments and Studies / HER2/EGFR in Cancer Research · Journal article
BMC Ophthalmology · September 10, 2026
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Two female patients with advanced cervical cancer receiving tisotumab vedotin developed sterile, neutrophilic pseudomembranous conjunctivitis after 2–3 doses, suggesting off-target cytotoxicity rather than infection. Both responded to topical corticosteroids and lubricants, but recurrence and variable prophylactic efficacy on retreatment highlight the need for systematic characterization of this adverse effect.
Case reports. Two female patients with advanced cervical cancer treated with tisotumab vedotin. Intervention: Tisotumab vedotin (TVfTV), with dose intervals and dosages variable between cases on retreatment. n = 2.
Pseudomembranous conjunctivitis onset after 2 to 3 doses of tisotumab vedotin in both patients Cytology showed neutrophilic infiltration with no detectable microorganisms Complete remission within two weeks with topical dexamethasone eye drops 4–5 times daily and lubricants
Case 1: side effects recurred after retreatment; prophylactic steroid drops (4 days) failed but intensified steroids succeeded; intraocular pressure increased after seventh dose
Clinicians prescribing tisotumab vedotin should monitor for pseudomembranous conjunctivitis and consider it a potential immune-mediated adverse effect requiring topical corticosteroid intervention. Management strategy (prophylaxis vs. extended intervals and dose reduction) may need individualization pending further experience.
Two uncontrolled case reports describing a newly recognized adverse effect of tisotumab vedotin, with cytological mechanistic insight but no comparative data or systematic incidence assessment.
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Clinicians prescribing tisotumab vedotin should monitor for pseudomembranous conjunctivitis and consider it a potential immune-mediated adverse effect requiring topical corticosteroid intervention. Management strategy (prophylaxis vs. extended intervals and dose reduction) may need individualization pending further experience.
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Abstract Background Tisotumab vedotin-tfTV (TV), an antibody-drug conjugate (ADC), represents a significant advancement in cancer therapy but carries the potential to induce ocular surface toxicity. Having encountered ocular side effects with TV and obtained intriguing findings from histological examination, we discuss the pathophysiology and management approaches. Cases Two female patients with advanced cervical cancer receiving TV therapy developed pseudomembranous conjunctivitis after 2 to 3 doses. Both cases presented with conjunctival hyperemia and pseudomembrane formation on the tarsal conjunctiva. One case additionally exhibited multiple epithelial erosions on the inferior conjunctiva. Cytology of the pseudomembrane showed neutrophilic infiltration but no detectable microorganisms. This suggested an immune-mediated erosion, such as a tissue factor-mediated reaction in the conjunctival epithelium. Complete remission was achieved within two weeks with topical corticosteroids (dexamethasone eye drops: 4–5 times daily) and lubricants. In both cases, after achieving grade 0 by extending the treatment interval, re-treatment was performed; however, ocular side effects recurred in Case 1. Four days of prophylactic steroid eye drops failed to prevent side effects, but intensifying steroid eye drops allowed inflammation to resolve without sequelae. Nevertheless, intraocular pressure increased after the seventh dose. In Case 2, after side effects appeared, TV administration was resumed with extended intervals and reduced dosage; no conjunctivitis side effects were observed under the recommended prophylactic protocol. Both patients have now completed the seventh dose. Conclusions TV may cause pseudomembranous conjunctivitis with conjunctival erosion characterized by non-infectious neutrophilic infiltration, suggesting off-target cytotoxicity. Further case accumulation is necessary for the appropriate management of TV-induced ophthalmic side effects.
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