Retinal Toxicity Associated with Nab-Paclitaxel and Gemcitabine with SBP-101

Purpose: To document retinal toxicity from nab-paclitaxel and gemcitabine with SBP-101, diethyl dihydroxyhomospermine, a polyamine inhibitor for the treatment of metastatic pancreatic adenocarcinoma. Methods: Observational case report. Results: Two patients with metastatic pancreatic ductal adenocarcinoma on nab-paclitaxel and gemcitabine with SBP-101 were found to have retina pigmentary changes and retinal pigment epithelium (RPE) mottling. Spectral domain optical coherence tomography (OCT) showed RPE and outer retinal speckled reflectivity in the nasal and superior macula in both eyes. Subsequent follow-up visits demonstrated progression of these findings despite discontinuation of the drug. Visual acuity (VA) remained stable or slightly worsened from baseline. Conclusion: These cases highlight retinal toxicity of the clinical trial drug nab-paclitaxel and gemcitabine with SBP-101 and the need to monitor these patients with regular ophthalmology examinations.