• Martina Sanlorenzo, Aditi Choudhry, Igor Vujic, Christian Posch, Kim Chong, Katia Johnston, Melissa Meier, Simona Osella-Abate, Pietro Quaglino, Adil Daud, Alain Algazi, Klemens Rappersberger, and Susana Ortiz-Urda.
• University of California-San Francisco, Mt Zion Cancer Research Center, San Francisco, California; Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy. Electronic address: martina.sanlorenzo@hotmail.it.
• J. Am. Acad. Dermatol. 2014 Dec 1;71(6):1102-1109.e1.

BackgroundBRAF inhibitor (BRAFi) and MEK inhibitor (MEKi) frequently cause cutaneous adverse events.ObjectiveWe sought to investigate the cutaneous safety profile of BRAFi versus BRAFi and MEKi combination regimens.MethodsWe performed a retrospective cohort study, collecting data from 44 patients with melanoma treated either with BRAFi (vemurafenib or dabrafenib) or BRAFi and MEKi combination regimens (vemurafenib + cobimetinib or dabrafenib + trametinib). Patient characteristics, and the occurrence and severity of cutaneous adverse events, are described.ResultsThe development of cutaneous adverse events was significantly less frequent (P = .012) and occurred after longer treatment time (P = .025) in patients treated with BRAFi and MEKi combination regimen compared with patients treated with BRAFi monotherapy. Among patients who received both BRAFi and the combination of BRAFi and MEKi at different time points during their treatment course, the development of squamous cell carcinoma or keratoacanthoma was significantly less frequent when they received the combination regimen (P = .008). Patients receiving vemurafenib developed more cutaneous adverse events (P = .001) and in particular more photosensitivity (P = .010) than patients who did not.LimitationsThere were a limited number of patients.ConclusionCombination regimen with BRAFi and MEKi shows fewer cutaneous adverse events and longer cutaneous adverse event-free interval compared with BRAFi monotherapy.Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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