Related Experiment Video
Updated: Apr 29, 2026
Spatial and Temporal Control of Murine Melanoma Initiation from Mutant Melanocyte Stem Cells
Published on: June 7, 2019
Transient MEK inhibitor-associated retinopathy in metastatic melanoma
U Urner-Bloch1, M Urner2, P Stieger3
1Private Ophthalmic Practice in Cooperation with the Skin Cancer Unit, University Hospital of Zurich, Zurich.
Background:
Melanoma is one of the most aggressive skin cancers. Recently, selective MEK inhibitors have shown efficacy in patients with advanced BRAF- and NRAS-mutant melanoma. Soon after the initiation of clinical oncology trials with MEK inhibitors, it was observed that some participants developed an eye condition resembling central serous chorioretinopathy. The present article addresses the clinical features and management of these MEK inhibitor-associated retinal syndromes.
Patients And Methods:
Thirty-two patients with advanced cutaneous melanoma were treated with the selective MEK inhibitor binimetinib (MEK162) in three different Phase 1b or 2 clinical trials. Twenty patients on binimetinib monotherapy and 12 on binimetinib plus RAF inhibitor [pan-kinase RAF inhibitor RAF265 (n = 7) or selective BRAF inhibitor encorafenib (LGX818) (n = 5)] combination therapy underwent ophthalmological examinations at regular intervals, including determination of best corrected visual acuity, perimetry, colour vision testing, dilated fundus examination, and multimodal imaging.
Results:
Grade 1-2 bilateral retinopathies with multiple lesions were observed in 13 of 20 patients on binimetinib monotherapy, 4 of 7 patients on binimetinib plus RAF265 combination therapy, and 2 of 5 patients on binimetinib plus encorafenib combination therapy. In this study population, the rate ranged from 40% to 65%. Retinopathy events appeared during the first 4 weeks, and in some cases, during the first few days of treatment. Patients reported mild and only short-lived visual symptoms. Optical coherence tomography revealed neuroretinal elevations. Central retinal thickness and volume showed dose-dependent increases after the start of treatment, followed by a marked decrease despite continued treatment, which was associated with symptom resolution. No vascular abnormalities were found with fluorescein and indocyanine green angiography.
Conclusions:
Treatment with the selective MEK inhibitor binimetinib as a single agent or in combination with RAF inhibitors induced transient retinopathy with multiple bilateral lesions in some patients. Binimetinib-induced retinopathy was usually mild, self-limiting, and tolerable as visual function was not seriously impaired.
Insights
Selective MEK inhibitors like binimetinib can cause transient retinopathy in melanoma patients. This eye condition is usually mild, self-limiting, and does not severely impair vision.
Area of Science:
- Ophthalmology
- Oncology
- Pharmacology
Background:
- Melanoma is an aggressive skin cancer.
- MEK inhibitors show efficacy in advanced melanoma.
- MEK inhibitors can cause eye conditions similar to central serous chorioretinopathy.
Purpose of the Study:
- To address the clinical features and management of MEK inhibitor-associated retinal syndromes.
- To investigate binimetinib-induced retinopathy in melanoma patients.
Main Methods:
- Thirty-two patients with advanced cutaneous melanoma received binimetinib monotherapy or combination therapy.
- Ophthalmological examinations and multimodal imaging were performed at regular intervals.
- Optical coherence tomography (OCT) and angiography were utilized.
Main Results:
- Grade 1-2 bilateral retinopathies occurred in 40-65% of patients.
- Retinopathy events appeared within the first 4 weeks of treatment.
- OCT revealed neuroretinal elevations and dose-dependent increases in retinal thickness, followed by resolution despite continued treatment.
Conclusions:
- Binimetinib, alone or with RAF inhibitors, can induce transient retinopathy.
- The retinopathy is typically mild, self-limiting, and tolerable.
- Visual function is not seriously impaired by binimetinib-induced retinopathy.
