Study Compares Skin Toxicities of MEK Inhibitors in Children

TOPLINE:

MEK inhibitors are frequently associated with cutaneous adverse events in pediatric patients, and binimetinib was associated with more severe reactions than selumetinib in a retrospective study, which also found a significant association with age and the type of skin reactions experienced.

METHODOLOGY:

To learn more about the cutaneous adverse events of MEK inhibitors in children, researchers conducted a single-center retrospective review of 46 patients in a pediatric registry of children treated with MEK inhibitors (mean age, 11.7 years; 23 girls and 23 boys) for low-grade gliomas and plexiform neurofibromas at New York University Langone Health, New York City, from 2016 through 2022.
The 33 patients on binimetinib had an average of six dermatology visits over an average of 20.1 months of treatment, while the 13 patients on selumetinib had an average of two visits over an average of 10.3 months of treatment.
The study looked at cutaneous toxicities, the correlation of adverse events with age and tumor response, and the differences in toxicities between the two.

TAKEAWAY:

Overall, dermatologic adverse events affected all but one of the patients (97.8%); the most common were acneiform eruptions (63.0%), paronychia (58.7%), and xerosis (54.3%).
Patients ≥ 12 years showed higher rates of acneiform eruption (P P P = .037).
Severe adverse events occurred more frequently with binimetinib than with selumetinib (90.9% vs 46.2%; P = .002). More patients who received binimetinib also required a dose reduction or hold on treatment because of cutaneous adverse events (87.9% vs 46.2%; P = .006).
Folliculitis and hair pigment dilution were reported only with binimetinib (39.4% vs 0% with selumetinib; P = .009). The severity of cutaneous events was not associated with tumor response.

IN PRACTICE:

“Dermatologic adverse events of MEK inhibitors are common and potentially severe, but important differences may exist depending on the specific MEK inhibitor used. While larger studies are needed, selumetinib may result in less severe cutaneous toxicity compared to binimetinib,” the authors wrote.

SOURCE:

The study was led by Carli D. Needle, Department of Dermatology, New York University, New York City, and was published online on November 07, 2024, in Pediatric Dermatology.

LIMITATIONS:

The study was limited by its retrospective nature and single-center design, along with an uneven distribution of patients between the two treatment groups. The assessment of tumor response was restricted to a chart review of radiographic imaging data. For patients who switched between therapies, prior exposure to a different MEK inhibitor may have influenced subsequent cutaneous reactions.

DISCLOSURES:

No specific funding was received for this study. One author reported serving on the scientific advisory board of Alexion Pharmaceuticals, and another author reported doing consulting work for Alexion Pharmaceuticals related to selumetinib.

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