Vogt-Koyanagi-Harada disease-like uveitis after drug therapy including BRAF/MEK inhibitors in melanoma patients with HLA-DRB1*04

Ryo Amagai; Taku Fujimura; Emi Yamazaki; Manami Takahashi; Erika Tamabuchi; Yumi Kambayashi; Akira Hashimoto; Kazuki Hashimoto; Yoshihide Asano

doi:10.1111/1346-8138.17082

Vogt-Koyanagi-Harada disease-like uveitis after drug therapy including BRAF/MEK inhibitors in melanoma patients with HLA-DRB1*04

J Dermatol. 2023 Dec 19. doi: 10.1111/1346-8138.17082. Online ahead of print.

Authors

Ryo Amagai¹, Taku Fujimura¹, Emi Yamazaki¹, Manami Takahashi¹, Erika Tamabuchi¹, Yumi Kambayashi¹, Akira Hashimoto¹, Kazuki Hashimoto², Yoshihide Asano¹

Affiliations

¹ Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.
² Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.

PMID: 38111371
DOI: 10.1111/1346-8138.17082

Abstract

The combination of BRAF kinase inhibitors (BRAFis) and MEK kinase inhibitors (MEKis) is one of the most promising chemotherapy regimens in the treatment of BRAF-mutant melanoma. Although BRAFi plus MEKi combined therapy is widely used for the treatment of BRAF^V600 -mutated melanoma, the incidence of uveitis caused by BRAFi plus MEKi is limited. In this report, we described five cases (two men and three women) of Vogt-Koyanagi-Harada (VKH) disease-like uveitis in melanoma patients who received BRAFi plus MEKi combined therapy. Of note, all the patients had the HLA-DRB1*04 haplotype, which is frequently detected in VKH-like non-infectious uveitis. On the other hand, among BRAFi plus MEKi-treated patients who did not develop VKH disease-like uveitis, only one of five (20%) patients had the HLA-DRB1*04 haplotype. Collectively, BRAFi/MEKi might induce severe VKH disease-like uveitis in melanoma patients with the HLA-DRB1*04 haplotype.

Keywords: BRAF/MEK inhibitor; HLA-DRB1*04; VKH disease-like uveitis; adverse event; melanoma.