Acute Radiation Skin Toxicity Possible With BRAF Inhibitors

A recent abstract addressed this very topic:

On-demand Gamma Knife combined with BRAF inhinitors for the treatment of melanoma brain metastases.
Abstract 9083 J Clin Oncol
Marqueste, Carron, Delsanti, et al (out of France)

Cases of radiosensitization after conventional radiation therapy in BRAFi treated patients had caused concern about using this combo.  In this study, blind review by 2 independent observers of brain MRI f/u scans and survival assessment in all patients treated with Gamma knife and BRAFi at a single institution, was completed.  Gamma knife was done on 30 patients who had previously been given BRAFi, 24 patients were under BRAFi treatment (with only 4 of those interrupting the BRAFi for the gamma knife procedure) and 15 patients had Gamma knife before starting BRAFi.  Out of 263 brain mets treated, only 3 edemas and 3 hemorrhages were detected within 2 months of gamma knife and 4/7 were noted later.  No brain met radiation necrosis and no scalp radiation dermatitis occurred.  Neither the MRI features nor the incidence of the rare adverse events were deemed unexpected in such a population.  Conclusion:  This series does not show immediate radiotoxicity nor radiation-recall in BRAFi patients treated with Gamma knife.  Interrupting  BRAFi for stereotactic radiosurgery of brain mets seems useless.

Hope this helps.  Celeste

A recent abstract addressed this very topic:

On-demand Gamma Knife combined with BRAF inhinitors for the treatment of melanoma brain metastases.
Abstract 9083 J Clin Oncol
Marqueste, Carron, Delsanti, et al (out of France)

Cases of radiosensitization after conventional radiation therapy in BRAFi treated patients had caused concern about using this combo.  In this study, blind review by 2 independent observers of brain MRI f/u scans and survival assessment in all patients treated with Gamma knife and BRAFi at a single institution, was completed.  Gamma knife was done on 30 patients who had previously been given BRAFi, 24 patients were under BRAFi treatment (with only 4 of those interrupting the BRAFi for the gamma knife procedure) and 15 patients had Gamma knife before starting BRAFi.  Out of 263 brain mets treated, only 3 edemas and 3 hemorrhages were detected within 2 months of gamma knife and 4/7 were noted later.  No brain met radiation necrosis and no scalp radiation dermatitis occurred.  Neither the MRI features nor the incidence of the rare adverse events were deemed unexpected in such a population.  Conclusion:  This series does not show immediate radiotoxicity nor radiation-recall in BRAFi patients treated with Gamma knife.  Interrupting  BRAFi for stereotactic radiosurgery of brain mets seems useless.

Hope this helps.  Celeste

A recent abstract addressed this very topic:

On-demand Gamma Knife combined with BRAF inhinitors for the treatment of melanoma brain metastases.
Abstract 9083 J Clin Oncol
Marqueste, Carron, Delsanti, et al (out of France)

Cases of radiosensitization after conventional radiation therapy in BRAFi treated patients had caused concern about using this combo.  In this study, blind review by 2 independent observers of brain MRI f/u scans and survival assessment in all patients treated with Gamma knife and BRAFi at a single institution, was completed.  Gamma knife was done on 30 patients who had previously been given BRAFi, 24 patients were under BRAFi treatment (with only 4 of those interrupting the BRAFi for the gamma knife procedure) and 15 patients had Gamma knife before starting BRAFi.  Out of 263 brain mets treated, only 3 edemas and 3 hemorrhages were detected within 2 months of gamma knife and 4/7 were noted later.  No brain met radiation necrosis and no scalp radiation dermatitis occurred.  Neither the MRI features nor the incidence of the rare adverse events were deemed unexpected in such a population.  Conclusion:  This series does not show immediate radiotoxicity nor radiation-recall in BRAFi patients treated with Gamma knife.  Interrupting  BRAFi for stereotactic radiosurgery of brain mets seems useless.

Hope this helps.  Celeste