Higher Uveitis Risk in Cancer Patients on BRAF Inhibitors

TOPLINE:

In patients with skin or lung cancer, drugs that inhibit BRAF (v-raf murine sarcoma viral oncogene homolog B) mutations increase the risk for uveitis dramatically compared with conventional chemotherapy and immunotherapy.

METHODOLOGY:

• This retrospective cohort study assessed 77,323 patients with skin melanoma or lung cancer from South Korea between January 2011 and September 2022.
• A total of 396 patients received BRAF inhibitors (vemurafenib, dabrafenib, and dabrafenib-trametinib combination), 22,474 received immune checkpoint inhibitors, and 54,453 were treated with conventional chemotherapy.
• The main outcome was the incidence of noninfectious uveitis.

TAKEAWAY:

• The cumulative incidence of uveitis was 0.33% in the chemotherapy group, 0.35% in the immunotherapy group, and 2.27% in the group that received BRAF inhibitors.
• The incidence of severe uveitis was 0.12%, 0.14%, and 1.01%, respectively.
• Compared with chemotherapy and immunotherapy, BRAF inhibitors increased the risk for uveitis by 7.52- and 5.68-folds, respectively; the respective risk for severe uveitis rose by 9.53- and 6.40-folds (P < .001 for all).
• This risk for uveitis increased by 3.71-fold after exposure to BRAF inhibitors when compared with the pretreatment period (P = .046).

IN PRACTICE:

“The results of our study emphasize the importance of providing thorough pretreatment education on the potential risk of BRAF inhibitor-associated uveitis to patients receiving BRAF inhibitors, especially for those who have been diagnosed with skin melanoma. Such education would prompt seeking of ophthalmic evaluation and treatment in case of symptom occurrence during drug administration,” the authors wrote.

SOURCE:

This study was led by Hyunjean Jung, MD, from the Department of Ophthalmology of the Institute of Vision Research at the Yonsei University College of Medicine in Seoul, South Korea, and published online on July 6, 2024, in the American Journal of Ophthalmology.

LIMITATIONS:

The study’s reliance on medical claims data limited the ability to delineate specific subtypes of uveitis. Most patients received dabrafenib in combination with trametinib, making it difficult to assess the impact of trametinib alone. The study’s findings may not be generalizable to populations outside of South Korea.

DISCLOSURES:

The study was supported by the Korea Health Industry Development Institute and the Ministry of Health and Welfare, Republic of Korea. The authors declared no conflicts of interest.

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