July 24, 2015
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BRAF inhibitors, Tafinlar/Mekinist for metastatic melanoma differed in cutaneous toxic effects

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Cutaneous toxic effects differed between Tafinlar, Zelboraf or a combination of Tafinlar and Mekinist in patients with metastatic melanoma, according to recently published study results.

Researchers conducted a retrospective cohort study between Sept. 1, 2009, to Nov. 30, 2013, of 185 patients with unresectable stage IIIC or IV melanoma referred to the department of dermatology, Westmead Hospital, New South Wales, Australia. The study included 119 patients who received Tafinlar (dabrafenib, Novartis), 36 who received Zelboraf (vemurafenib, Genentech) and 30 who received a combination of dabrafenib with Mekinist (trametinib dimethyl sulfoxide, Novartis).

In patients treated with single-agent dabrafenib or vemurafenib, common cutaneous adverse events included Grover disease (42.9% and 38.9%, respectively), plantar hyperkeratosis (39.5% and 38.9%), verrucal keratosis (66.4% and 72.2%), and cutaneous squamous cell carcinoma (SCC; 26.1% and 36.1%). Fourteen patients treated with vemurafenib (38.9%) experienced photosensitivity compared with one patient in the dabrafenib-treated cohort (0.8%; P<.001). Patients in the dabrafenib/trametinib therapy cohort had a higher frequency of folliculitis (40% vs. 8%;), a decrease in cutaneous SCC (0 vs. 26.1%), verrucal keratosis (0 vs. 66.4%) and Grover disease (0 vs. 42.9%; P<.001, for all) compared with patients treated dabrafenib alone.

“Patients treated with BRAF inhibitors alone or in combination with the MEK inhibitor trametinib require careful and ongoing dermatologic monitoring throughout their treatment,” the researchers concluded. “Recognition of the variety of cutaneous toxic effects associated with these different therapies, including the predisposing risk factors for their development, is important with the purpose of ensuring appropriate rapid intervention and thereby abrogating the need to delay or even withholding these essential treatments.” – By Bruce Thiel

Disclosure: Carlos reports no relevant financial disclosures. Please see the study for a full list of the other researchers’ relevant financial disclosures.