title: Progression of KRAS mutant pancreatic adenocarcinoma during vemurafenib treatment in a patient with metastatic melanoma.
abstract: Vemurafenib is a tyrosine kinase inhibitor of BRAF that prolongs survival in patients with BRAF V600-mutant metastatic melanoma. Secondary cutaneous malignancies are a well-documented toxicity of vemurafenib, thought to be mediated by enhanced ERK signalling in BRAF wild-type, RAS-mutant cells. Vemurafenib could also promote growth of non-cutaneous secondary malignancies by a similar mechanism. We present a case of an individual who received vemurafenib for metastatic melanoma and experienced rapid growth of a pre-existing KRAS-mutant pancreatic adenocarcinoma.
authors.affiliation: Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Grey
authors.forename: A
authors.initials: A
authors.lastname: Cooper
authors.forename: C
authors.initials: C
authors.lastname: McNeil
authors.forename: S
authors.initials: S
authors.lastname: O'Toole
authors.forename: J
authors.initials: J
authors.lastname: Thompson
authors.forename: P
authors.initials: P
authors.lastname: Grimison
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000235:genetics* / Q000628:therapy; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000069287:Capecitabine; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D017809:Fatal Outcome; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D011905:Genes, ras; D006801:Humans; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000628:therapy; D009154:Mutation; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000235:genetics* / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics* / Q000628:therapy; D049268:Positron-Emission Tomography; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011518:Proto-Oncogene Proteins / Q000235:genetics; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D016283:Proto-Oncogene Proteins p21(ras); D012878:Skin Neoplasms / Q000188:drug therapy*; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D000077484:Vemurafenib; D018631:ras Proteins / Q000235:genetics
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; C117307:KRAS protein, human; D047428:Protein Kinase Inhibitors; D011518:Proto-Oncogene Proteins; D013449:Sulfonamides; D003841:Deoxycytidine; D000077484:Vemurafenib; D000069287:Capecitabine; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins; D005472:Fluorouracil
keywords: BRAF inhibitor; melanoma; pancreatic adenocarcinoma; secondary malignancy; vemurafenib