Department of Dermatology and Allergy, Hannover Medical School, Skin Cancer Center Hannover, Hannover, Germany.
Dermatology. 2010;221(3):193-6. doi: 10.1159/000317081.
The multikinase inhibitor sorafenib is therapeutically used in various malignancies. Multiple cutaneous side effects are well described but recent reports indicated a possible association of epithelial skin cancer growth during sorafenib therapy. To our knowledge, few cases of actinic keratoses and variants of squamous cell carcinomas associated with sorafenib have been published. We report 2 patients who developed a basal cell carcinoma (BCC) while treated with sorafenib. Interestingly BCC is a tumor which has not been described yet in association with sorafenib therapy. The tumors were excised completely. After termination of sorafenib treatment, no new BCCs or other epithelial skin cancers occurred. There is accumulating evidence in the literature that sorafenib and possibly other targeted agents are associated with an increased occurrence of epithelial skin cancers. These observations are summarized here and complemented by the new observation that also BCCs might be associated with sorafenib therapy. The pathogenetic mechanisms are unclear so far but induction of the mitogen-activated protein kinase pathway in wild-type RAF cells by RAF inhibitors might play a role. Patients should be informed of this possible side effect and undergo regular dermatological controls before and during sorafenib therapy.
多激酶抑制剂索拉非尼在多种恶性肿瘤的治疗中得到了应用。已充分描述了多种皮肤副作用，但最近的报告表明，在索拉非尼治疗期间可能与上皮性皮肤癌的生长有关。据我们所知，很少有报道称角化棘皮瘤和鳞状细胞癌的变异与索拉非尼有关。我们报告了 2 例在接受索拉非尼治疗期间发生基底细胞癌（BCC）的患者。有趣的是，BCC 是一种尚未被描述与索拉非尼治疗有关的肿瘤。肿瘤被完全切除。停止索拉非尼治疗后，未再发生新的 BCC 或其他上皮性皮肤癌。文献中有越来越多的证据表明，索拉非尼和其他可能的靶向药物与上皮性皮肤癌的发生率增加有关。这些观察结果在这里进行了总结，并补充了新的观察结果，即 BCC 也可能与索拉非尼治疗有关。目前尚不清楚其发病机制，但 RAF 抑制剂在野生型 RAF 细胞中诱导丝裂原活化蛋白激酶途径可能起作用。在开始索拉非尼治疗前和治疗期间，应告知患者这种可能的副作用，并进行定期的皮肤科检查。
