TOPLINE:

Most patients with vascular anomalies treated with the mitogen-activated protein kinase (MEK) inhibitors, trametinib and selumetinib, experienced cutaneous adverse events (CAEs).

METHODOLOGY:

• Researchers conducted a retrospective review of 48 patients (median age, 15 years; 52% male) who were treated with MEK inhibitors for vascular anomalies at Boston Children’s Hospital and Children’s Hospital of Philadelphia, Philadelphia, between January 1999 and April 2024.
• All patients received trametinib, and five patients subsequently received selumetinib because of CAEs from trametinib or lack of response. The patients were followed up for 21 months after treatment started.
• Six patients received concurrent mTOR inhibitors, and five patients received prednisone for the vascular anomaly.
• The study outcome was the rate of CAEs and their impact on the treatment course.

TAKEAWAY:

• CAEs occurred in 42 (88%) patients on trametinib and four (80%) patients on selumetinib.
• Overall, treatment with MEK inhibitors resulted in 91 CAEs. Most were grade 1 (54%) or grade 2 events (40%); 7% were grade 3. The most common CAEs were acne (43%) and eczematous dermatitis (37%).
• Patients experienced a mean of 1.9 CAEs each (range, 0-7); 62% of patients saw a dermatologist for these side effects.
• CAEs led to dose adjustments in 25% of patients on trametinib and 60% on selumetinib and discontinuation of treatment in 27% of patients on trametinib and none in patients on selumetinib.

IN PRACTICE:

“Multidisciplinary approaches between hematology-oncology and dermatology to manage CAEs could help minimize therapy disruptions,” the authors of the study wrote. “Published prevention strategies for CAEs for oncology therapy patients undergoing MEKi should be implemented for vascular anomaly patients, including fragrance-free cleansers and emollients, irritant avoidance, and nail trimming techniques,” they added.

SOURCE:

The study was led by Isabella Plumptre, MBBS, Vascular Anomalies Center, Boston Children’s Hospital, Boston, and was published online on December 22 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The study was limited by its retrospective design and small patient numbers, particularly for selumetinib cases. Distinguishing CAEs from disease activity, such as skin ulceration, was difficult.

DISCLOSURES:

The study received financial support through the Women’s Dermatologic Society Mentorship Award, the New England Dermatological Society Early Career Mentorship Award, and the Vascular Anomalies Center at Boston Children’s Hospital. Two authors disclosed consulting for and/or being an investigator for Palvella Therapeutics and Relay Therapeutics.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.