Vemurafenib and Radiosensitization
Open Access
- 1 July 2013
- journal article
- case report
- Published by American Medical Association (AMA) in JAMA Dermatology
- Vol. 149 (7), 855-857
- https://doi.org/10.1001/jamadermatol.2013.4200
Abstract
Importance TheBRAFinhibitor, vemurafenib, was recently approved for the treatment of patients withBRAFV600metastatic melanoma. Wider use of this drug and longer follow-up periods of treatment are resulting in the emergence of a growing number of reports detailing new adverse effects. Cutaneous adverse effects are preeminent with UV-A–dependent phototoxicity, hyperkeratotic folliculitis, hand-foot skin reaction, hair changes, verrucous papillomas, keratoacanthomas, and squamous cell carcinomas. Observations We report 2 cases of dermatitis occurring on a previously irradiated skin area in patients treated with vemurafenib for aBRAFV600-mutated metastatic melanoma. The first case occurred 10 days after a low dose of radiation was delivered that usually does not induce any radiodermatitis, suggesting radiosensitization by vemurafenib. The second case occurred 30 days after radiotherapy and was diagnosed as radiation recall dermatitis. Conclusions and Relevance Vemurafenib should be considered a potential cutaneous radiosensitizer and an inducer of radiation recall dermatitis. However, these adverse effects are easily managed with topical corticosteroids. Dose reduction or interruption of vemurafenib is not required. Further studies and reports will enlighten us as to whether this pharmacodynamic interaction between x-rays and vemurafenib is also seen with otherBRAForMEKinhibitors on the same mitogen-activated protein kinase pathway currently under development.Keywords
This publication has 10 references indexed in Scilit:
- Ultraviolet A and Photosensitivity during Vemurafenib TherapyNew England Journal of Medicine, 2012
- Improved Survival with Vemurafenib in Melanoma with BRAF V600E MutationNew England Journal of Medicine, 2011
- Radiation recall dermatitis triggered by multi-targeted tyrosine kinase inhibitors: sunitinib and sorafenibAnti-Cancer Drugs, 2010
- Radiation recall reaction with docetaxel administration after accelerated partial breast irradiation with electronic brachytherapyBrachytherapy, 2009
- IL12RB2 and ABCA1 Genes Are Associated with Susceptibility to Radiation DermatitisClinical Cancer Research, 2008
- Tamoxifen-Induced Radiation Recall DermatitisAmerican Journal of Clinical Oncology, 2006
- An Unusual Case of Gemcitabine-Induced Radiation RecallAmerican Journal of Clinical Oncology, 2006
- Radiation dermatitis: Clinical presentation, pathophysiology, and treatment 2006Journal of the American Academy of Dermatology, 2006
- Radiation Recall Dermatitis May Represent the Koebner PhenomenonJournal of Clinical Oncology, 2002
- Characterizing the phenomenon of radiation recall dermatitisRadiotherapy and Oncology, 2001