Bennani-Lahlou M, Mateus C, Escudier B, Massard C, Soria J-C, Spatz A, Robert C
Institut Gustave-Roussy, 39 rue Camille-Desmoulins, Villejuif cedex, France.
Ann Dermatol Venereol. 2008 Oct;135(10):672-4. doi: 10.1016/j.annder.2008.04.016. Epub 2008 Jul 30.
Sorafenib is a new multikinase inhibitor recently approved for renal cell carcinoma and hepatocarcinoma. Among other targets, it blocks the kinase function of the RAF gene products including V600E mutant BRAF, which is frequently found in both melanoma and naevi. Cutaneous side effects are frequent with sorafenib, but no naevus modification has been reported until now.
Five cases of eruptive naevi in patients treated with sorafenib are reported. The mean duration of sorafenib treatment was 9.2 months when naevi eruption was noticed. The patients presented with about 100 to more than 200 small, homogenous, dark-brown naevi located mainly on the trunk and upper limbs.
Eruptive melanocytic naevi have been reported in association with blistering diseases, and more generally in a setting of immunosuppression. We hypothesize that naevi appearance could be linked to an anti-senescence effect of sorafenib via its action on the MAP kinase pathway. Further prospective studies are needed to explore the relationship between sorafenib and the biology of naevi.
索拉非尼是一种新型多激酶抑制剂，最近被批准用于治疗肾细胞癌和肝癌。除其他靶点外，它可阻断包括V600E突变型BRAF在内的RAF基因产物的激酶功能，V600E突变型BRAF在黑色素瘤和痣中均常见。索拉非尼治疗时皮肤副作用很常见，但迄今为止尚未有痣改变的报道。
报告了5例接受索拉非尼治疗的患者出现的发疹性痣。发现痣发疹时索拉非尼治疗的平均持续时间为9.2个月。患者主要在躯干和上肢出现约100至200多个小的、均匀的深褐色痣。
已报道发疹性黑素细胞痣与水疱性疾病有关，更普遍的是与免疫抑制有关。我们推测痣的出现可能与索拉非尼通过其对MAP激酶途径的作用产生的抗衰老效应有关。需要进一步的前瞻性研究来探索索拉非尼与痣生物学之间的关系。
