Blechman Adam B, Cabell Christine E, Weinberger Christine H, Duckworth Anna, Leitenberger Justin J, Zwald Fiona O, Russell Mark A
J Drugs Dermatol. 2017 May 1;16(5):508-511.
The Food and Drug Administration approved Ruxolitinib in 2011 for the treatment of primary myelofibrosis. Five-year safety data showed a higher incidence of skin cancer in patients treated with Ruxolitinib compared to best available therapy for myelofibrosis. This report presents a series of five patients with history of myelofibrosis treated with Ruxolitinib who subsequently developed numerous skin cancers with aggressive biological behavior. Each patient in this report was treated by a Mohs surgeon affiliated with an academic institution. All patients had a history of myelofibrosis and were exposed to Ruxolitinib. Some patients were exposed to other immunomodulatory medications such as Hydroxyurea and Rituximab. The total number of skin cancers and skin cancers with particularly aggressive behavior were noted. All five patients in this series developed numerous skin cancers with aggressive biological behavior during or after therapy with Ruxolitinib. Also, one patient developed lentigo maligna melanoma and another developed metastatic undifferentiated pleomorphic sarcoma. The repeat observation of skin cancers with aggressive features during JAK inhibitor treatment suggests that these medications may promote cutaneous malignant transformation in at risk patients. Further surveillance and testing of JAK kinases regarding the risk of skin cancers is indicated.
J Drugs Dermatol. 2017;16(5):508-511.
.美国食品药品监督管理局于2011年批准芦可替尼用于治疗原发性骨髓纤维化。五年安全性数据显示，与骨髓纤维化的最佳可用疗法相比，接受芦可替尼治疗的患者皮肤癌发病率更高。本报告介绍了5例有骨髓纤维化病史且接受芦可替尼治疗的患者，这些患者随后发生了许多具有侵袭性生物学行为的皮肤癌。本报告中的每位患者均由一所学术机构附属的莫氏外科医生进行治疗。所有患者均有骨髓纤维化病史并接触过芦可替尼。一些患者还接触过其他免疫调节药物，如羟基脲和利妥昔单抗。记录了皮肤癌的总数以及具有特别侵袭性行为的皮肤癌。该系列中的所有5例患者在接受芦可替尼治疗期间或之后均发生了许多具有侵袭性生物学行为的皮肤癌。此外，1例患者发生了恶性雀斑样痣黑色素瘤，另1例患者发生了转移性未分化多形性肉瘤。在JAK抑制剂治疗期间反复观察到具有侵袭性特征的皮肤癌，提示这些药物可能促使有风险的患者发生皮肤恶性转化。有必要对JAK激酶在皮肤癌风险方面进行进一步监测和检测。
《皮肤药物学杂志》2017年；16(5):508 - 511。
