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Open Access High Incidence of Naevi-associated BRAF Wild-type Melanoma and Dysplastic Naevi under Treatment with the Class I BRAF Inhibitor Vemurafenib

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There is growing evidence that not only malign keratinocytic but also melanocytic tumours can arise during treatment with vemurafenib. During an on-going early access trial, 13 patients harbouring a BRAF-V600E mutation received vemurafenib (Zelboraf®) 960 mg twice daily to test the safety, tolerability, efficacy and response rate for advanced melanoma. Clinically or dermatoscopically suspicious cutaneous tumours under treatment with vemurafenib were excised. The BRAF-V600E status of confirmed new primary melanoma and dysplastic naevi was tested using a genetic mutation assay and immunohistochemistry. Four of the 13 patients (31%) developed 4 new naevi-associated malignant melanomas and 5 dysplastic naevi between 6 weeks and 6 months after the start of treatment. With the exception of one in situ melanoma, all tumours were BRAF wild-type. Immunohistochemistry revealed increased expression of ERK, pERK and active Rac1-GTP in the naevi-associated melanoma and dysplastic naevi. Careful and continuous skin examination, including dermoscopy, appears to be required during treatment with vemurafenib.

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Keywords: NAEVI-ASSOCIATION; NEW PRIMARY MELANOMA; RAC1; VEMURAFENIB

Document Type: Research Article

Publication date: September 1, 2014

More about this publication?
  • Acta Dermato-Venereologica is a bi-monthly international peer-reviewed journal for clinical and experimental research in the field of dermatology and venereology.

    It was founded in 1920 by Johan Almqvist and edited during 1936-1969 by Sven Hellerström. Since 1970, the journal has been published for the Society for the Publication of Acta Dermato-Venereologica on a non-profit basis.

    Acta Dermato-Venereologica publishes high-quality manuscripts in English dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs to enhance understanding.

    Acta Dermato-Venereologica covers inter alia:

    • ~ Atopic dermatitis and contact allergy
    • ~ Facial dermatoses and adnexal disorders
    • ~ New treatments
    • ~ Psoriasis and genodermatoses
    • ~ Psychodermatology
    • ~ Sexually transmitted diseases
    • ~ Skin biology and inflammation
    • ~ Skin cancer and pigmentation
    • ~ Skin immunology and lymphoma
    • ~ Urticaria and itch

    Extensive papers, proceedings from congresses and symposia are printed as supplements to the journal. Announcements concerning pertinent dermatological meetings and books received are also published.
    Readership: Doctors and scientists interested in dermatology, skin biology and venereology.

    Acta Dermato-Venereologica has an impact factor of 3.007.

    Issues between 1998 up to 2005 can be found at http://www.medicaljournals.se/acta/content

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