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Radiation recall dermatitis and radiation pneumonitis during treatment with vemurafenib

Forschner, Andreaa; Zips, Danielb; Schraml, Christinac; Röcken, Martina; Iordanou, Elenia; Leiter, Ulrikea; Weide, Benjamina; Garbe, Clausa; Meier, Friedegunda

Melanoma Research:
doi: 10.1097/CMR.0000000000000078
Short Communications
Abstract

The basis of radiation recall reactions (RRR) is a subclinical radiation damage that is uncovered later by treatment with anticancer agents. Several drugs have been associated with RRR, in particular taxanes and anthracyclines. Recently, a few cases were reported concerning radiation recall dermatitis caused by vemurafenib. Up to now, there have been no reports of RRR in the lung induced by vemurafenib. We describe the occurrence of RRR in three melanoma patients who had undergone radiotherapy for metastases followed by systemic treatment with the BRAF inhibitor vemurafenib. Two patients developed radiation recall pneumonitis (RRP) and one patient developed radiation recall dermatitis (RRD) 5–7 weeks after the radiation treatment was finished and 2–4 weeks after vemurafenib was started. The early application of systemic (RRP) and topical corticosteroids (RRD) enabled us to continue the treatment with vemurafenib without dose reduction. Caution is needed when vemurafenib is planned for patients who have undergone previous radiotherapy, and RRR of the skin and the lung have to be taken into account.

Author Information

Departments of aDermatology

bRadiooncology

cRadiology, Eberhard-Karls University of Tübingen, Tübingen, Germany

Correspondence to Claus Garbe, MD, PhD, Department of Dermatology, Division of Dermatologic Oncology, Eberhard-Karls University of Tuebingen, Liebermeisterstr. 25, D-72076 Tübingen, Germany Tel: +49 07071 2987110; fax: +49 07071 295187; e-mail: claus.garbe@med.uni-tuebingen.de

Received April 18, 2013

Accepted March 18, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins