Acute radiation skin toxicity associated with BRAF inhibitors

BRAF inhibitors, vemurafenib and dabrafenib, are the mainstay of treatmentfor BRAF-mutant metastatic melanoma. Cutaneous toxicities are themostfrequent adverse effects, particularly hyperkeratosis (6% to 51% with vemurafenib), as well as cutaneous squamous cell carcinoma and keratoacanthoma (4.3% to 31% with vemurafenib, 6% to 11% with dabrafenib).1 Photosensitivity can occur in 52% of patients treated with vemurafenib. Radiation therapy plays an important role in the treatment of patients with metastatic melanoma. In this report, we describe five patients who experienced unanticipated increased in-field skin toxicity while undergoing radiotherapy with the concomitant use of BRAF inhibitors