The prevalence of cutaneous toxic effects differs among the BRAF inhibitors, vemurafenib and dabrafenib, alone and in combination with the MEK inhibitor, trametinib, a new study published online in JAMA Oncology has shown.

For the study, researchers sought to directly compare cutaneous adverse effects of vemurafenib, dabrafenib, and dabrafenib plus trametinib in patients with metastatic melanoma.

Researchers retrospectively analyzed data from 185 Australian patients with unresectable stage 3C and 4 melanoma who received treatment at Westmead Hospital in Australia between September 2009 to November 2013. Of those, 119 patients received dabrafenib, 36 received vemurafenib, and 30 received combination dabrafenib-trametinib therapy.

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Results showed that photosensitivity occurred in 38.9% of those who received vemurafenib compared with 0.8% of those who received dabrafenib (P<0.001). In addition, folliculitis occurred in 40% in the combination group versus 6.7% in the dabrafenib group (P<0.001).

Researchers observed a significant decrease in the incidence of cutaneous squamous cell carcinoma, Grover disease, and verrucal keratosis in patients who received combination therapy compared with those who received dabrafenib (all P<0.001).

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The authors note that the incidence of cutaneous squamous cell carcinoma among patients who received BRAF monotherapy is concerning.

The findings ultimately suggest that dermatologic assessments should performed on all patients who are receiving these treatments for metastatic melanoma.


  1. Carlos G, Anforth R, Clements A, et al. Cutaneous toxic effects of BRAF inhibitors alone and in combination with MEK inhibitors for metastatic melanoma. JAMA Oncol. 2015. [epub ahead of print]. doi: 10.1001/jamadermatol.2015.1745.