QOL-28. CUTANEOUS REACTIONS TO TARGETED THERAPIES IN CHILDREN WITH CNS TUMORS: A CROSS-SECTIONAL STUDY

摘要

The MAPK and mTOR pathways play important roles in cell proliferation. BRAF, MEK, and mTOR inhibitors are novel therapies that inhibit these pathways and are increasingly utilized in the pediatric population with CNS tumors. While associated cutaneous reactions are common, data in children are sparse. The objective of this cross-sectional study was to investigate the frequency and type of cutaneous reactions in children with brain tumors treated with BRAF, MEK, and mTOR inhibitor monotherapy. Patients less than 21 years of age with CNS tumors on BRAF V600E (dabrafenib), MEK (trametinib), or mTOR inhibitors (everolimus) were enrolled over a one-year period. Twenty-two patients were enrolled, including 11 on MEK inhibitors, 6 on BRAF V600E inhibitors, and 5 on mTOR inhibitors. Median age at study visit was 12 years (3-19 yrs). Ninety-six percent (21/22) of patients had at least one skin finding. In patients on the MEK inhibitors (11), common reactions were follicular eruptions (9), xerosis (8), paronychia (4), and alopecia (2). In patients on the BRAF inhibitors (6), common reactions included follicular eruptions (6), hand-foot syndrome (5), and xerosis (3). In patients on the mTOR inhibitors (5), reactions included xerosis (4), paronychia (1), and follicular eruption (1). Two patients on the MEK inhibitors and one patient on the BRAF inhibitor required therapy cessation due to severe cutaneous reactions. Treatment was recommended for study participants as indicated. The study demonstrates that cutaneous reactions were extremely common but generally well-tolerated, though for a small subset, their reactions were severe and required therapy cessation.