title: Prospective study of cutaneous side-effects associated with the BRAF inhibitor vemurafenib: a study of 42 patients.
abstract: BACKGROUND
  BRAF inhibitors are being developed for the treatment of metastatic melanoma harboring a V600E mutation. The use of vemurafenib significantly increases progression-free survival (PFS) and overall survival (OS) in this population of patients, but is associated with numerous adverse skin reactions.
  
  
  METHODS
  We carried out a systematic dermatologic study of 42 patients treated with vemurafenib. We collected detailed dermatologic symptoms, photos and biopsy specimens of the skin lesions which enabled us to classify the side-effects. The management and evolution of the skin symptoms are also reported.
  
  
  RESULTS
  All patients presented with at least one adverse skin reaction. The most common cutaneous side-effects consisted in verrucous papillomas (79%) and hand-foot skin reaction (60%). Other common cutaneous toxic effects were a diffuse hyperkeratotic perifollicular rash (55%), photosensitivity (52%) and alopecia (45%). Epidermoid cysts (33%) and eruptive nevi (10%) were also observed. Keratoacanthomas (KA) and squamous cell carcinoma (SCC) occurred in 14% and 26% of the patients, respectively.
  
  
  CONCLUSIONS
  These cutaneous side-effects are cause of concern due to their intrinsic potential for malignancy or because of their impact on patients' quality of life. Management of this skin toxicity relies on symptomatic measures and sun photoprotection.
authors: Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
authors: L
authors: L
authors: Boussemart
authors: E
authors: E
authors: Routier
authors: C
authors: C
authors: Mateus
authors: K
authors: K
authors: Opletalova
authors: G
authors: G
authors: Sebille
authors: N
authors: N
authors: Kamsu-Kom
authors: M
authors: M
authors: Thomas
authors: S
authors: S
authors: Vagner
authors: M
authors: M
authors: Favre
authors: G
authors: G
authors: Tomasic
authors: J
authors: J
authors: Wechsler
authors: L
authors: L
authors: Lacroix
authors: C
authors: C
authors: Robert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors* / Q000378:metabolism; D012867:Skin / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology*; D012871:Skin Diseases / Q000139:chemically induced / Q000175:diagnosis; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D013449:Sulfonamides / Q000008:administration & dosage* / Q000009:adverse effects*; D000077484:Vemurafenib
chemical_list: D007211:Indoles; D013449:Sulfonamides; D000077484:Vemurafenib; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: BRAF inhibitor; melanoma; side-effects; squamous cell carcinoma-targeted therapy; vemurafenib