title: A case of vemurafenib-induced polyarhritis in a patient with melanoma: how to manage it?
abstract: Vemurafenib is an inhibitor of the BRAF V600E mutation which is associated with tumor responses in patients with metastatic melanoma. Although it is generally well tolerated, common side effects of vemurafenib have been reported. Arthralgia is one of the more common adverse event associated with vemurafenib. We herein report a 49-year-old woman diagnosed with metastatic melanoma harboring the BRAF V600E mutation with severe polyarthritis associated with vemurafenib after 7 days of treatment. Sonographic examination of affected joints revealed synovitis and the patient's articular symptoms were improved by analgesic and anti-inflammatory treatment, including corticosteroids. During therapy with selective BRAF inhibitors, arthritis represents a new adverse event that can require dose reduction. In case of this adverse event, treatment with anti-inflammatory drugs, such as ibuprofen and prednisone, should be initiated early to keep patients on treatment and to avoid drug discontinuation and tumor progression.
authors.affiliation: Department of Oncology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Babacan
authors.affiliation: Department of Internal Medicine, School of Medicine, Adıyaman University, Adiyaman, Turkey.
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Türkbeyler
authors.affiliation: Department of Oncology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Balakan
authors.affiliation: Department of Rheumatology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Pehlivan
authors.affiliation: Department of Oncology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Suner
authors.affiliation: Department of Rheumatology, School of Medicine, Gaziantep University, Gaziantep, Turkey.
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Kısacık
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001168:Arthritis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D008545:Melanoma / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics / Q000556:secondary; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors / Q000235:genetics; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D013449:Sulfonamides / Q000009:adverse effects*; D016896:Treatment Outcome; D014463:Ultrasonography; D000077484:Vemurafenib
chemical_list: D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D007211:Indoles; D047428:Protein Kinase Inhibitors; D013449:Sulfonamides; D000077484:Vemurafenib; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: BRAF inhibitor; polyarthritis; vemurafenib