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Published on: August 3, 2011
Cutaneous effects of BRAF inhibitor therapy: a case series
P L Mattei1, M B Alora-Palli1, S Kraft2
1Departments of Dermatology.
Background:
The cutaneous effects of rapidly accelerated fibrosarcoma kinase B (BRAF) inhibitors are not well understood. Squamous cell carcinoma (SCC), keratoacanthoma, and photosensitivity have been described in patients taking BRAF inhibitors.
Patients And Methods:
To characterize the timing and frequency of skin lesions in patients receiving BRAF inhibitor therapy, we utilized a retrospective case review of 53 patients undergoing treatment with BRAF inhibitors for 4-92 weeks of therapy. Patients were evaluated at baseline, and then followed at 4- to 12-week intervals. Charts were retrospectively reviewed, and the morphology and timing of cutaneous events were recorded.
Results:
Thirty-three of the 53 charts met exclusion/inclusion criteria, 15 were treated with vemurafenib, and 18 were treated with GSK 2118436/GSK 1120212. Of 33 patients treated with BRAF inhibitor, 13 developed photosensitivity (39.4%), 10 developed actinic keratoses (30.3%), 10 developed warts (30.3%), and 6 developed SCC (18.2%).
Conclusions:
Multiple cutaneous findings were observed in the 33 patients taking BRAF inhibitors. The previously described association with SCC and photosensitivity was observed in these patients as well. Over half of the observed SCCs were invasive in nature. Photosensitivity continues to be frequent with BRAF inhibitors. Patients taking BRAF inhibitors should have regular full body skin exams. Further studies are necessary to better elucidate the rates of these adverse cutaneous effects.
Insights
BRAF inhibitors can cause skin issues like squamous cell carcinoma (SCC) and photosensitivity. Regular skin exams are recommended for patients undergoing BRAF inhibitor therapy to monitor these adverse effects.
Area of Science:
- Dermatology
- Oncology
- Pharmacology
Background:
- Cutaneous side effects of BRAF inhibitors are not fully understood.
- Previous reports link BRAF inhibitors to squamous cell carcinoma (SCC), keratoacanthoma, and photosensitivity.
Purpose of the Study:
- To characterize the timing and frequency of skin lesions in patients receiving BRAF inhibitor therapy.
- To document adverse cutaneous events associated with BRAF inhibitors.
Main Methods:
- Retrospective case review of 53 patients treated with BRAF inhibitors.
- Evaluation at baseline and 4- to 12-week intervals.
- Recording of morphology and timing of cutaneous events.
Main Results:
- 33 patients met inclusion criteria; 15 received vemurafenib, 18 received GSK 2118436/GSK 1120212.
- 13 patients (39.4%) developed photosensitivity.
- 10 patients (30.3%) developed actinic keratoses, 10 (30.3%) developed warts, and 6 (18.2%) developed SCC.
Conclusions:
- BRAF inhibitors are associated with multiple cutaneous findings, including SCC and photosensitivity.
- Over half of SCCs observed were invasive.
- Photosensitivity is a frequent adverse effect; regular skin exams are advised for patients on BRAF inhibitors.
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