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Ophthalmologic Monitoring in Pemazyre Therapy: Why It Matters for Patient Safety and Treatment Success
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Precision medicine has redefined the success criterion for a therapy like Pemazyre. Although overall survival rate is the foremost essential component, managing its complications are equally important for a positive outcome. Do you also agree with it? Come, let me take you through one of the frequently reported complications during the usage of Pemazyre capsules.
What is Pemazyre (Pemigatinib) treatment?
Fibroblast Growth Factor Receptors (FGF/FGFR) play an important signalling role in cellular growth, proliferation and its repair. The signalling system initiates when the FGF unites with FGFR proteins located on the surface of the cells. The functions of this process may be helpful in tissue formation, wound healing, blood vessel formation and organ functioning under normal instances.
Tumors start occurring when the mutations or gene fusions are associated with the FGFR gene. The well-known mutation is a type of bile duct cancer named FGFR2 fusion-positive cholangiocarcinoma. In these cases, the FGFR signals are switched on permanently that may lead to uncontrolled production of cancer cells.
Pemazyre blocks the activity of FGFR1, FGFR2 and FGFR3. The mechanism of FGFR phosphorylation is inhibited. The downstream pathways that include MAPK, PI3K/APT pathway and STAT signalling activation reduces, thereby giving a tough time for the cancer for its growth and survival.
While Pemazyre aims at the FGFR which is not restricted to cancers but also present at the normal tissues such as eyes, skin, bones, kidney and blood vessels. So certain complications may occur which are listed below:
Hyperphosphatemia (increase in phosphate levels)
Retinal pigment epithelial detachment
Skin changes
Hair issues.
Eye changes
FGFR helps in retinal health and fluid balance within ocular tissues. Disturbance in FGFR may create issues such as fluid imbalance, structural changes and eye sight issues.
One of the severe types of complications is Retinal Pigment epithelial Detachment (RPED) that can be encountered in patients taking Pemazyre. It is defined as the detachment of retinal pigment from the underlying Bruch’s membrane due to accumulation of fluid, blood, extracellular deposits or its combinations. The symptoms of RPED include dry eyes, blurred vision, increased sensitivity to light, visual floaters and changes in central vision.
Some of the eye changes can occur even without symptoms. So ophthalmologic monitoring is mandatory to make out the subtle retinal changes during Pemazyre treatment.
Monitoring plan
A proper safety monitoring plan is recommended by ophthalmologists for patients in Pemazyre.
The tests are mentioned clearly at every stage of the treatment.
1. Prior to Pemazyre therapy
• Comprehensive ophthalmologic examination
• Baseline visual assessment
• Optical Coherence Tomography (OCT)
2. 1-6 months of therapy
• Eye examination every 2 months
• OCT at each visit
3. After 6 months
• Eye examination every 3 months
• OCT at each visit
4. After encountering of symptoms
• Immediate ophthalmologic consultation
• Additional OCT imaging
• Dose changes if required.