Multifocal serous retinopathy with pemigatinib therapy for metastatic colon adenocarcinoma.
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2021-04
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Abstract
Background
Pemigatinib is an inhibitor of the fibroblast growth factor receptor (FGFR), recently approved for the treatment of cholangiocarcinoma. FGFR retinopathy is a newly recognized entity, with only two other FGFR inhibitors reported to cause serous retinopathy. Herein, we describe the first published report of a multifocal serous retinopathy secondary to pemigatinib.Case presentation
A 67-year-old male with stage 4A metastatic colon adenocarcinoma undergoing systemic therapy with pemigatinib was found to have developed bilateral multifocal serous retinopathy. Fundus autofluorescence showed corresponding multifocal hypoautofluorescent foci, whereas fluorescein angiography and indocyanine green angiography were unremarkable. Subretinal fluid resolved rapidly after discontinuation of pemigatinib.Conclusions
Multifocal serous retinopathy appears to be a class effect of FGFR inhibitors. FGFR retinopathy clinically resembles MEK retinopathy-both feature multifocal subretinal fluid, low visual significance, and quick resolution. However, given that FGFR inhibitors have a broader molecular range than MEK inhibitors, further characterization of FGFR retinopathy is necessary to generate management guidelines.Type
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Alekseev, Oleg, Effy Ojuok and Scott Cousins (2021). Multifocal serous retinopathy with pemigatinib therapy for metastatic colon adenocarcinoma. International journal of retina and vitreous, 7(1). p. 34. 10.1186/s40942-021-00305-9 Retrieved from https://hdl.handle.net/10161/26128.
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Oleg Alekseev
Dr. Alekseev completed combined MD-PhD training at Drexel University College of Medicine and pursued post-doctoral fellowship training at the University of Pennsylvania School of Medicine. He completed Ophthalmology residency training at the University of North Carolina School of Medicine, where he also served as a chief resident. Dr. Alekseev pursued double-fellowship training in Medical Retina and Inherited Retinal Degenerations at the Duke Eye Center, where he then joined the faculty in 2022.
Dr. Alekseev is a member of the Duke Center for Retinal Degenerations and Ophthalmic Genetic Diseases. His clinical focus is on inherited retinal degenerations, including conditions like retinitis pigmentosa, Stargardt disease, macular pattern dystrophies, syndromic retinal degenerations, and mimickers like autoimmune and iatrogenic retinopathies. Dr. Alekseev’s patients have access to advanced diagnostic modalities, including electrophisiology testing, various types of perimetry testing, specialized retinal imaging, as well as genetic testing. In addition to his practice, Dr. Alekseev conducts clinical trials in rare genetic conditions of the retina, such as choroideremia and retinitis pigmentosa.
As a K08-scholar, Dr. Alekseev dedicates the majority of his time to basic and translational research in the laboratory. He is interested in developing gene-agnostic approaches to extend the longevity of ailing photoreceptors in conditions like retinitis pigmentosa, thereby preserving the vision of affected patients. The approaches he investigates include both gene-therapy and small-molecule-based therapeutic modalities.
Scott William Cousins
Scott W. Cousins, M.D. is currently the Robert Machemer, M.D. Professor of Ophthalmology and Immunology, Vice Chair for Research, and Director of the Duke Center for Macular Diseases at Duke Eye Center. As Vice Chair, he oversees all basic science research as well as the Ophthalmology Site-Based Research Group, which administrates clinical research for Duke Eye Center. Dr. Cousins is also Medical Director of Hospital-Based Imaging and Procedures for Duke Eye Center.
Dr. Cousins is a retina-trained ophthalmologist who specializes in the diagnosis and treatment of macular diseases, especially age-related macular degeneration (AMD), diabetic retinopathy, and retinal vascular diseases. Dr. Cousins is active in both clinical and laboratory research. In his clinical practice, Dr. Cousins is involved in many trials and innovative therapies for the treatment of macular diseases, especially AMD and diabetic retinopathy. He has served as site PI for numerous phase1-3 clinical trials in AMD, diabetic retinopathy, and other retinal disorders. He has served as a consultant or member of data safety monitoring committees (DSMC) for numerous pharmaceutical and biotechnology startup companies.
In his scientific laboratory, Dr. Cousins pursues both NIH-funded and industry-funded research in various areas of dry and wet AMD. In particular, he is studying the role of circulating bone marrow-derived progenitors (stem cells) in contributing to wet AMD. His laboratory is attempting to develop treatments for dry macular degeneration and improving vision in eyes with wet macular degeneration. His program is also developing blood tests and new imaging technologies for the identification of patients who are at high risk for progressing into complications.
Dr. Cousins has published over 100 peer-reviewed manuscripts, book chapters, and other publications addressing topics of research or clinical care of retinal disease, especially AMD. In 2006, Dr. Cousins was awarded the prestigious Alcon Research Foundation Clinician Scientist Award. In 2008, the National Institutes of Health invited Dr. Cousins to join the National Advisory Eye Council. Dr. Cousins is also a member of the American Academy of Ophthalmology, the American Society of Retina Specialists, the Retina Society, the Association for Research in Vision and Ophthalmology, the American Association of Immunologists, and the American Medical Association.
In 2010, Dr. Cousins was named one of the “Top 34 Ophthalmologists in the United States” by Becker’s ASC Review, a leading source of business and legal news for ambulatory surgery centers. They cited his leadership of the Duke Center for Macular Diseases and his ongoing research in macular degeneration as reasons for the honor.
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