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Purpose <p>S-1 is an orally active anticancer drug known to cause ocular adverse events (AEs), including lacrimal passage obstruction and corneal complications. This study investigated tear concentrations of 5-fluorouracil (5-FU) and tegafur (FT) in patients receiving S-1 treatment and their relationship with ocular AEs.</p> Study design <p>Multicenter prospective cohort study.</p> Methods <p>We recruited patients scheduled for S-1 chemotherapy. After initial ophthalmologic examinations at enrollment, serial examinations were performed during the courses of S-1 administration for up to 1 year. Tear samples were collected using Schirmer test strips at the end of the first course of S-1 treatment. 5-FU and FT concentrations were measured using high-performance liquid chromatography.</p> Results <p>The study cohort comprised 94 patients among whom 38 (40.4%) developed ocular AEs, including 32 (34.0%) corneal AEs, 13 (13.8%) lacrimal AEs, and 7 (7.4%) patients who developed both. The tear FT concentrations in the ocular AE group were significantly higher compared with the group without ocular AEs (3.15 ± 3.09 vs. 1.86 ± 1.56 µg/mL; <i>p</i> = 0.017). There was no difference in tear 5-FU concentration between the 2 groups. The FT concentration in tears in the corneal and lacrimal AE groups was significantly higher than in the group without ocular AEs (<i>p</i> = 0.013 and 0.030, respectively).</p> Conclusion <p>FT concentration in tears due to oral S-1 therapy is associated with corneal or lacrimal AEs. Measuring FT concentration in tears or plasma may be useful for predicting the onset of ocular AEs.</p>

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Ocular complication induced by anticancer drug S-1: association with drug concentrations in tears

  • 期刊论文

  • 发表日期：

    2025年3月17日

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  • Masakazu Yamada,
  • Tomoyuki Kamao,
  • Atsushi Shiraishi,
  • Jo Sakai,
  • Yuichi Ohashi,
  • Masashi Mimura,
  • Yoshitsugu Inoue,
  • Kazuyoshi Ohtomo,
  • Tai-ichiro Chikama,
  • Chika Miyazaki,
  • Yuka Hosotani

摘要

Purpose

S-1 is an orally active anticancer drug known to cause ocular adverse events (AEs), including lacrimal passage obstruction and corneal complications. This study investigated tear concentrations of 5-fluorouracil (5-FU) and tegafur (FT) in patients receiving S-1 treatment and their relationship with ocular AEs.

Study design

Multicenter prospective cohort study.

Methods

We recruited patients scheduled for S-1 chemotherapy. After initial ophthalmologic examinations at enrollment, serial examinations were performed during the courses of S-1 administration for up to 1 year. Tear samples were collected using Schirmer test strips at the end of the first course of S-1 treatment. 5-FU and FT concentrations were measured using high-performance liquid chromatography.

Results

The study cohort comprised 94 patients among whom 38 (40.4%) developed ocular AEs, including 32 (34.0%) corneal AEs, 13 (13.8%) lacrimal AEs, and 7 (7.4%) patients who developed both. The tear FT concentrations in the ocular AE group were significantly higher compared with the group without ocular AEs (3.15 ± 3.09 vs. 1.86 ± 1.56 µg/mL; p = 0.017). There was no difference in tear 5-FU concentration between the 2 groups. The FT concentration in tears in the corneal and lacrimal AE groups was significantly higher than in the group without ocular AEs (p = 0.013 and 0.030, respectively).

Conclusion

FT concentration in tears due to oral S-1 therapy is associated with corneal or lacrimal AEs. Measuring FT concentration in tears or plasma may be useful for predicting the onset of ocular AEs.