Simultaneous Treatment of Severe Vemurafenib-induced Uveitis and Metastatic Melanoma

Abstract

Background: Vemurafenib, a serine-threonine kinase inhibitor, has been used to treat unresectable metastatic melanoma since 2011. Ocular adverse events are reported to be seldom and to regress after the discontinuation of vemurafenib and therapy with topical steroids. However, this approach must be weighed against the potential progression of melanoma. We present alternative options in uveitis treatment enabling the continuation of vemurafenib therapy.

A Rare Cause of Uveitis: Vemurafenib

“…The second is a possible inflammatory response to antigens shared by melanocytes in the melanoma and the choroid. 3,5 The period between the first administration of vemurafenib treatment and initial uveitis symptoms was reported to vary from 1 to 85 weeks (average of 27). 5…”

“…4 Reported systemic adverse effects of vemurafenib are arthralgia (53%), alopecia (45%), fatigue (38%), nausea (35%), and photosensitivity (33%). 5 In addition, uveitis was the most commonly reported adverse event related to vemurafenib administration, followed by conjunctivitis and dry eye (4%, 2.8%, and 2%, respectively). 3 Adverse events must be weighed against the potential survival benefit.…”

“…When it comes to uveitis, steroids were reported to suppress ocular inflammation; however, some authors were in favor of cessation of the therapy. 5…”