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  • Callahan, Margaret K; Rampal, Raajit; Harding, James J; Klimek, Virginia M; Chung, Young Rock; Merghoub, Taha; Wolchok, Jedd D; Solit, David B; Rosen, Neal; Abdel-Wahab, Omar; Levine, Ross L; Chapman, Paul B

    The New England journal of medicine, 12/2012, Letnik: 367, Številka: 24
    Journal Article

    Vemurafenib, a selective RAF inhibitor, extends survival among patients with BRAF V600E-mutant melanoma. Vemurafenib inhibits ERK signaling in BRAF V600E-mutant cells but activates ERK signaling in BRAF wild-type cells. This paradoxical activation of ERK signaling is the mechanistic basis for the development of RAS-mutant squamous-cell skin cancers in patients treated with RAF inhibitors. We report the accelerated growth of a previously unsuspected RAS-mutant leukemia in a patient with melanoma who was receiving vemurafenib. Exposure to vemurafenib induced hyperactivation of ERK signaling and proliferation of the leukemic cell population, an effect that was reversed on drug withdrawal.