Abstract
Docetaxel is an antineoplastic chemotherapy agent widely used in the treatment of a variety of malignancies. Despite its widespread use, ocular toxicities remain rare and literature is sparse regarding the identification and management of these toxicities, especially when they occur in combination with dermatologic toxicities. Here, we report two cases of combined ocular and dermatologic toxicities caused by the administration of docetaxel. Case 1 describes a 64-year-old man who developed epiphora, eye discharge, eyelid margin sores, and facial rash after cycle 2 of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy for esophageal adenocarcinoma. Case 2 describes a 50-year-old woman with breast cancer who developed a widespread erythematous, desquamating rash with ocular lesions and discharge after cycle 2 of docetaxel-containing chemotherapy. Both cases included a previously reported, less serious constellation of symptoms one cycle prior to the onset of the more severe reaction(s) and concurrent presentation of significant dermatologic and ocular adverse events. Rapid identification and intervention under the care of both the oncology team and an ophthalmologist are crucial to minimize morbidity.
References
Bolognia, J. L., Cooper, D. L., & Glusac, E. J. (2008). Toxic erythema of chemotherapy: A useful clinical term. Journal of the American Academy of Dermatology, 59(3), 524–529. https://doi.org/10.1016/j.jaad.2008.05.018
Esmaeli, B. (2005). Management of excessive tearing as a side effect of docetaxel. Clinical Breast Cancer, 5(6), 455–457. https://doi.org/10.3816/cbc.2005.n.004
Esmaeli, B., Ahmadi, M. A., Rivera, E., Valero, V., Hutto, T., Jackson, D. M., & Newman, R. A. (2002). Docetaxel secretion in tears: Association with lacrimal drainage obstruction. Archives of Ophthalmology, 120(9), 1180–1182.
Fortes, B. H., Liou, H., & Dalvin, L. A. (2022). Ophthalmic adverse effects of taxanes: The Mayo Clinic experience. European Journal of Ophthalmology, 32(1), 602–611. https://doi.org/10.1177/1120672120969045
Kaya, A. O., Buyukberber, S., Coskun, U., Yildiz, R., Ozturk, B., Yaman, E., Adisen, E., Gureli, M., & Benekli, M. (2008). Acute erythema and edematous skin reaction and ectropion following docetaxel in a patient with non-small cell lung cancer. Cutaneous and Ocular Toxicology, 27(4), 327–331. https://doi.org/10.1080/15569520802431369
National Cancer Institute. (2025). Common Terminology Criteria for Adverse Events (CTCAE) v6.0 (MedDRA 28.0). https://dctd.cancer.gov/research/ctep-trials/for-sites/adverse-events/ctcae-v6.pdf
Sandoz. (2023). Docetaxel injection, 10 mg/mL: Highlights of prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/201525s024lbl.pdf
Sanofi Aventis. (1996). TAXOTERE (docetaxel) Injection, 40 mg/mL: Highlights of prescribing information. https://products.sanofi.us/taxotere/taxotere.pdf
Sodhi, M., Yeung, S. N., Maberley, D., Mikelberg, F., & Etminan, M. (2022). Risk of ocular adverse events with taxane-based chemotherapy. JAMA Ophthalmology, 140(9), 880–884. https://doi.org/10.1001/jamaophthalmol.2022.3026
Yamagishi, T., Ochi, N., Yamane, H., Hasebe, S., & Takigawa, N. (2014). Epiphora in lung cancer patients receiving docetaxel: A case series. BMC Research Notes, 7, 322. https://doi.org/10.1186/1756-0500-7-322