title: Radiation recall dermatitis and radiation pneumonitis during treatment with vemurafenib.
abstract: The basis of radiation recall reactions (RRR) is a subclinical radiation damage that is uncovered later by treatment with anticancer agents. Several drugs have been associated with RRR, in particular taxanes and anthracyclines. Recently, a few cases were reported concerning radiation recall dermatitis caused by vemurafenib. Up to now, there have been no reports of RRR in the lung induced by vemurafenib. We describe the occurrence of RRR in three melanoma patients who had undergone radiotherapy for metastases followed by systemic treatment with the BRAF inhibitor vemurafenib. Two patients developed radiation recall pneumonitis (RRP) and one patient developed radiation recall dermatitis (RRD) 5-7 weeks after the radiation treatment was finished and 2-4 weeks after vemurafenib was started. The early application of systemic (RRP) and topical corticosteroids (RRD) enabled us to continue the treatment with vemurafenib without dose reduction. Caution is needed when vemurafenib is planned for patients who have undergone previous radiotherapy, and RRR of the skin and the lung have to be taken into account.
authors.affiliation: Departments of aDermatology bRadiooncology cRadiology, Eberhard-Karls University of Tübingen, Tübingen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Forschner
authors.forename: Daniel
authors.initials: D
authors.lastname: Zips
authors.forename: Christina
authors.initials: C
authors.lastname: Schraml
authors.forename: Martin
authors.initials: M
authors.lastname: Röcken
authors.forename: Eleni
authors.initials: E
authors.lastname: Iordanou
authors.forename: Ulrike
authors.initials: U
authors.lastname: Leiter
authors.forename: Benjamin
authors.initials: B
authors.lastname: Weide
authors.forename: Claus
authors.initials: C
authors.lastname: Garbe
authors.forename: Friedegund
authors.initials: F
authors.lastname: Meier
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects / Q000528:radiation effects; D008168:Lung / Q000187:drug effects* / Q000528:radiation effects*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D008875:Middle Aged; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D017564:Radiation Pneumonitis / Q000139:chemically induced*; D011855:Radiodermatitis / Q000139:chemically induced*; D012867:Skin / Q000187:drug effects / Q000528:radiation effects; D013449:Sulfonamides / Q000009:adverse effects*; D016896:Treatment Outcome; D000077484:Vemurafenib
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D007211:Indoles; D013449:Sulfonamides; D000077484:Vemurafenib; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf