TOXICITY AND EFFICACY OF INTRAVITREAL MELPHALAN FOR RETINOBLASTOMA 25 mu g Versus 30 mu g

• Type of Material: Article
• Authors: Albert Liao, Emory University; Terry Hsieh, Memorial Sloan-Kettering Cancer Center; Jasmine H Francis, Memorial Sloan-Kettering Cancer Center; Jessica A Lavery, Memorial Sloan-Kettering Cancer Center; Audrey Mauguen, Memorial Sloan-Kettering Cancer Center; Scott E Brodie, NYU Langone Health, New York; David H Abramson, Memorial Sloan-Kettering Cancer Center
• Language: English
• Date: 2021-01-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020, Wolters Kluwer Health
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/IAE.0000000000002782
• Title of Journal or Parent Work: RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
• Volume: 41
• Issue: 1
• Start Page: 208
• End Page: 212
• Grant/Funding Information: Supported in part by grants from the Fund for Ophthalmic Knowledge, Inc. New York, N.Y. and Cancer Center Support Grant (P30 CA008748). The sponsor or funding organization had no role in the design or conduct of this research.
• Keywords: retinoblastoma; antineoplastic agents; intravitreal injection; melphalan; treatment outcomes; electroretinography; Life Sciences & Biomedicine; retinal neoplasms; Ophthalmology; vitreous seeds; retina; Science & Technology; drug effects

Abstract

PURPOSE: To compare retinal toxicity as measured by electroretinogram, ocular, and patient survival in retinoblastoma treated with intravitreal melphalan at two concentrations (25 vs. 30 µg). METHODS: Single-center, retrospective analysis of retinoblastoma eyes receiving 25-µg or 30-µg intravitreal melphalan from September 2012 to January 2019. Ocular toxicity was measured by electroretinogram of evaluable injections in 449 injections in 136 eyes. A repeated-measures linear mixed model with a random intercept and slope was applied to account for repeated measures for each eye. RESULTS: Average decline in electroretinogram after each additional injection was -4.9 µV (95% confidence interval -6.3 to -3.4); electroretinogram declined by -4.6 µV (95% confidence interval -7.0 to -2.2) after 25-µg injections and -5.2 µV (95% confidence interval -6.6 to -3.8) after 30-µg injections (P = 0.66). Injection at a new clock site hour was associated with a -3.91-µV lower average (95% confidence interval -7.8 to -0.04). CONCLUSION: Electroretinogram-measured toxicity in retinoblastoma eyes treated with intravitreal injections was not found to be different across 25-µg and 30-µg injections. There were no cases of extraocular extension or metastatic deaths in our patient population.