Onset of vitiligo following targeted therapy for BRAFV600E-mutated melanoma: case report

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Authors
Sonia Brugnara MD, Mariacristina Sicher MD, Elena Maria Bonandini MD, Mattia Barbareschi MD, Carlo Renè Girardelli MD, Orazio Caffo MD

Article Type
Case Report

DOI
10.7573/dic.212582

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Abstract

Systemic treatment for metastatic melanoma has advanced dramatically in recent years with an impressive increase in the rate of overall survival. The two main different strategies are targeted therapies (i.e. BRAF and MEK inhibitors) and immunotherapy with monoclonal antibodies against the immune checkpoint proteins programmed death-1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4). Vitiligo often accompanies immunotherapy in melanoma patients and even correlates with tumor regression after checkpoint blockade. At present, a correlation between vitiligo onset and outcome from immunotherapy is acknowledged; however, evidence of a correlation between vitiligo and efficacy of combination-targeted therapy is lacking. We describe our experience in a patient who received dabrafenib and trametinib and developed vitiligo-like depigmentation after treatment cessation.

Keywords: BRAF, immune system activation, MEK, melanoma, targeted therapy, vitiligo, V600E mutation.

Citation: Brugnara S, Sicher M, Bonandini EM, Barbareschi M, Girardelli CR, Caffo O. Onset of vitiligo following targeted therapy for BRAFV600E-mutated melanoma: case report. Drugs in Context 2019; 8: 212582. DOI: 10.7573/dic.212582

Contributions: Brugnara and Caffo were in charge of the patient; Sicher and Girardelli diagnosed vitiligo; Bonandini and Barbareschi performed histological examination. All authors contributed equally to the preparation of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at https://www.drugsincontext.com/wp-content/uploads/2019/11/dic.212582-COI.pdf

Acknowledgments: Medical writing for this manuscript was performed by Luca Giacomelli, PhD, on behalf of Content Ed Net, and by Aashni Shah (Polistudium, Milan, Italy).

Funding declaration: Medical writing assistance was supported by Novartis Farma (Origgio, Italy).

Copyright: Copyright © 2019 Brugnara S, Sicher M, Bonandini EM, Barbareschi M, Girardelli CR, Caffo O. https://doi.org/10.7573/dic.212582. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Brugnara S, Sicher M, Bonandini EM, Barbareschi M, Girardelli CR, Caffo O. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/onset-of-vitiligo-following-targeted-therapy-for-brafv600e-mutated-melanoma:-case-report/

Correspondence: Sonia Brugnara, Oncology Unit, S. Chiara Hospital, Trento, Italy. sonia.brugnara@apss.tn.it

Provenance: submitted; externally peer reviewed.

Submitted: 5 February 2019; Peer review comments to author: 13 March 2019; Revised manuscript received: 15 November 2019; Accepted: 21 November 2019; Publication date: 18 December 2019.

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