Abstract:
IMPORTANCE:Approximately 10% to 25% of patients treated with BRAF inhibitors develop cutaneous squamous cell carcinoma (SCC), but the mechanism responsible has not yet been determined. We report what we believe to be the first case in which Merkel cell polyomavirus (MCPyV) and human papillomavirus subtype 17 (HPV-17) were associated with cutaneous SCC that developed during treatment with the BRAF inhibitor dabrafenib. OBSERVATIONS:A 62-year-old woman with V600E BRAF -mutant metastatic melanoma enrolled in a phase 1 trial of dabrafenib, a selective inhibitor of V600-mutant BRAF kinase. During the first 6 weeks of treatment, the patient developed multiple skin lesions, including a 6-mm crusted papule on the left eyebrow, which was resected and, on pathology examination, revealed SCC. The DNA extracted from paraffin-embedded tissue was amplified by polymerase chain reaction for detection of MCPyV and epidermodysplasia verruciformis HPV (EV-HPV) types. Analysis of the cloned and sequenced polymerase chain reaction products revealed the presence of MCPyV and HPV-17 DNA. Other EV-HPV subtypes were not detected. CONCLUSIONS AND RELEVANCE:To our knowledge, this is the first report demonstrating the coexistence of MCPyV and HPV-17 in cutaneous SCC. Because both viruses have oncogenic potential, their role in the development of BRAF inhibitor-related SCC merits further investigation.
journal_name
JAMA Dermatoljournal_title
JAMA dermatologyauthors
Falchook GS,Rady P,Hymes S,Nguyen HP,Tyring SK,Prieto VG,Hong DS,Kurzrock Rdoi
10.1001/jamadermatol.2013.2023subject
Has Abstractpub_date
2013-03-01 00:00:00pages
322-6issue
3eissn
2168-6068issn
2168-6084pii
1670784journal_volume
149pub_type
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