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Cutaneous toxicities associated with vemurafenib therapy in 107 patients with BRAF V600E mutation‐positive metastatic melanoma, including recognition and management of rare presentations
Author(s) -
Sinha R.,
Larkin J.,
Gore M.,
Fearfield L.
Publication year - 2015
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.13958
Subject(s) - vemurafenib , medicine , rash , dermatology , dacarbazine , melanoma , adverse effect , keratoacanthoma , v600e , surgery , oncology , metastatic melanoma , cancer research , basal cell , mutation , gene , biochemistry , chemistry
Summary Background Vemurafenib significantly improved overall survival compared with dacarbazine in patients with metastatic or unresectable BRAF V600E‐positive melanoma in the BRIM ‐3 trial. However, vemurafenib was associated with a number of skin‐related adverse events ( AE s). Objectives To investigate the incidence and management of vemurafenib‐associated skin AE s. Methods This retrospective, observational study included adult patients with stage IIIC or IV melanoma who received vemurafenib between March 2010 and August 2013. Patients received oral vemurafenib 960 mg twice daily, with dose interruptions and reductions allowed for AE management. Results In total 107 patients were treated with vemurafenib during the study period. The most frequent clinically important skin‐related AE s were rash (64%), squamoproliferative growths (41%), photosensitivity (40%) and squamous cell carcinoma ( SCC ) or keratoacanthoma ( KA ; 20%). Rare cases of granulomatous dermatitis and cutaneous T‐cell lymphoma were also found. Rash was manageable with corticosteroids and dose modifications; squamoproliferative growths and SCC s/ KA s were treated with cryotherapy and surgical excision, respectively. Patients were counselled regarding phototoxicity. The uncontrolled nature and retrospective design of the study, and the small patient numbers are limitations. Conclusions Vemurafenib appears to have a predictable and manageable AE profile. Proactive management can limit the impact of AE s on patients, allowing treatment to continue despite toxicities.