Cutaneous Toxic Effects of BRAF Inhibitors Alone and in Combination With MEK Inhibitors

We have reviewed, in our population of patients with metastatic melanoma on targeted therapies, the cutaneous side effects of BRAF single agent (Dabrafenib or Vemurafenib) and the combination therapy (Dabrafenib + Trametinib). There are minimal differences between Dabrafenib and Vemurafenib (being photosensitivity the most important), but there are very significant differences between Dabrafenib and the combination Dabrafenib + Trametinib. There is a significative decrease in the number of Verrucal Keratosis and Squamous Cell Carcinomas in patients in combination therapy, with an increase in Folliculitis. Combination therapy has an improved profile of cutaneous toxic effects but still dermatologist have to be involved as 77% of the patients in Combination therapy are going to develop cutaneous toxic effects.