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Cutaneous Reactions in Pediatric Patients Treated with MEK Inhibitors: A Retrospective Single-Center Study
Rivka Friedland1,2, Mirit Glick1,2, Iris Amitay-Laish2,3
1Pediatric Dermatology Unit, Schneider Children's Medical Center, Petah Tiqva, Israel.
Insights
Mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors commonly cause skin issues in children. Most adverse events were mild, but frequent dermatology visits highlight patient distress and the need for specialized care.
Area of Science:
- Oncology
- Dermatology
- Pediatrics
Background:
- Mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors are widely used for various pediatric and adult conditions.
- Cutaneous toxicities are a frequent side effect associated with MEK inhibitor therapy.
- Understanding these skin-related adverse events in children is crucial for effective management.
Purpose of the Study:
- To characterize the spectrum, frequency, and severity of cutaneous adverse events in pediatric patients treated with MEK inhibitors.
- To compare the incidence of skin toxicities across different MEK inhibitors used in a pediatric cohort.
Main Methods:
- A retrospective review of pediatric patients treated with MEK inhibitors at a tertiary care center from January 2016 to January 2023.
- Data collection included patient demographics, MEK inhibitor type, and documented cutaneous adverse events.
Main Results:
- 76% of 33 pediatric patients experienced cutaneous adverse effects.
- Trametinib showed the highest prevalence (90%), followed by selumetinib (50%) and trametinib/dabrafenib combination (34%).
- Common events included xerosis, dermatitis, paronychia, and hair heterochromia, mostly graded as mild (1 or 2).
Conclusions:
- Cutaneous adverse events are prevalent in pediatric patients receiving MEK inhibitors, with a distinct clinical spectrum compared to adults.
- Despite being generally mild, these events cause significant distress, necessitating frequent dermatological consultations.
- Dermatologists play a vital role in the multidisciplinary care of pediatric patients undergoing MEK inhibitor treatment.
Introduction:
Mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors are in use for several indications for adults and children. Cutaneous toxicities are among the most common adverse effects. We aimed to describe the spectrum of cutaneous adverse events, its frequency, and severity in a cohort of pediatric patients.
Methods:
We reviewed all records of patients in our tertiary treatment center treated with MEK inhibitors between January 2016 and January 2023 for all indications.
Results:
Among 33 patients, 76% reported cutaneous adverse effects. The highest prevalence was in the group of patients treated with trametinib (90%), followed by the group treated with selumetinib (50%) and the group treated with a combination of trametinib and B-Raf proto-oncogene serine/threonine-protein kinase inhibitor (dabrafenib, 34%). Xerosis, dermatitis, paronychia, and hair heterochromia were most frequently reported. Severity was graded 1 or 2 for most adverse events, and 237 visits to the dermatology clinic related to these adverse events were recorded.
Conclusions:
Cutaneous adverse events are common in the pediatric population as in adults, but the clinical spectrum is different. Although considered mild, multiple dermatological consultations reflect the distress caused by these events. Dermatologists have a central role in the multidisciplinary care of pediatric patients receiving these agents.
