Rapidly growing pancreatic ductal adenocarcinoma in a patient with metastatic melanoma and harbouring CDKN2A germline mutation: A new vemurafenib-induced malignancy?

摘要

Selective BRAF inhibitors (vemurafenib) have demonstrated in large controlled trials impressive improvement of the overall and progression-free survivals of patients with BRAFV600-miitated advanced melanoma [1]. Cutaneous squamous cell carcinomas or papillomatous lesions, as well as atypical melanocytic proliferations and new primary melanomas have been, however, reported in vemurafenib-treated patients. A paradoxical activation of the MAPK pathway in cutaneous cells not harboring the BRAFV600 mutation has been postulated [2,3]. These skin cancers and proliferations are easily accessible to early diagnosis and excision, and no death has been reported yet. At present, no vemurafenib-induced internal malignancy has been reported. We report herein a rapidly growing pancreatic ductal adenocarcinoma in a vemurafenib-treated patient.