BRAF inhibition and the spectrum of granulomatous reactions

V-raf murine sarcoma viral oncogene homolog B1 (BRAF) inhibitors have emerged as a promising targeted therapy for malignancies with BRAF mutations, particularly metastatic melanoma. However, granulomatous reactions (GRs), including sarcoidosis and sarcoid-like reactions, have been reported as a cons...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2022-09, Vol.87 (3), p.605-613
Main Authors: Pham, James P., Star, Phoebe, Phan, Kevin, Loh, Yanni, Joshua, Anthony M., Smith, Annika
Format: Article
Language:English
Subjects:
BRAF inhibitor
dabrafenib
encorafenib
granuloma
granulomatous reaction
melanoma treatment
sarcoidosis
vemurafenib
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Summary:V-raf murine sarcoma viral oncogene homolog B1 (BRAF) inhibitors have emerged as a promising targeted therapy for malignancies with BRAF mutations, particularly metastatic melanoma. However, granulomatous reactions (GRs), including sarcoidosis and sarcoid-like reactions, have been reported as a consequence of BRAF inhibition. It is important to adequately characterize these GRs, including cutaneous manifestations and systemic involvement, in order to guide investigations and management. A literature review was conducted to characterize the spectrum of GRs associated with BRAF inhibitors, identifying 55 reactions affecting 51 patients, with 37 reactions limited to cutaneous involvement. Further, a possible correlation with cancer response, mechanisms of granuloma formation, and a proposed workup and management approach for these GRs are presented.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2021.10.030