Cutaneous reactions caused by BRAF, MEK inhibitors alter oncologic therapy in children

Children treated with BRAF and MEK inhibitors are prone to cutaneous reactions, many of which result in alterations or interruptions in oncologic therapy, reports a study.

“Treatment with BRAF inhibitors and MEK inhibitors causes cutaneous reactions in children, limiting dosing or resulting in treatment cessation,” the investigators said, adding that the spectrum and severity of these reactions was not defined.

This multicentre, retrospective study was conducted at 11 clinical sites in the US and Canada to determine the frequency and spectrum of cutaneous reactions in children receiving BRAF and MEK inhibitors, as well as their effects on continued therapy. Ninety-nine children treated with BRAF and/or MEK inhibitors for any indication from 1 January 2012 to 1 January 2018 were included in the analysis.

All 99 patients experienced a cutaneous reaction, and most had multiple reactions, with a mean per patient of 3.5 reactions on BRAF inhibitor, 3.7 on MEK inhibitor, and 3.4 on combination therapy. Three children stopped treatment due to a cutaneous reaction.

Treatment was altered in 27 percent, 39.5 percent, and 33 percent of patients on BRAF inhibitor, MEK inhibitor, and combination therapy, respectively. The following cutaneous reactions were most likely to alter treatment: dermatitis, panniculitis, and keratosis pilaris–like reactions for BRAF inhibitor and dermatitis, acneiform eruptions, and paronychia for MEK inhibitor.

“Implementing preventative strategies at the start of therapy may minimize cutaneous reactions,” the investigators said.