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Does Exposure to the Kinase Inhibitor Ruxolitinib Increase the Risk of Skin Cancer?

By: Joshua D. Madera, MS
Posted: Monday, April 18, 2022

For patients with polycythemia vera or myelofibrosis treated with the kinase inhibitor ruxolitinib, the risk of developing squamous cell carcinoma may be increased, according to a 10-year retrospective cohort study published in the Journal of the American Academy of Dermatology. Therefore, increased frequency of skin cancer monitoring is recommended in this patient population for earlier intervention, according to Anne Lynn Su Chang, MD, of Stanford University School of Medicine, Redwood City, California, and colleagues.

“Larger, prospective, multicenter studies may confirm the findings in this study, better delineate the optimal frequency of skin examinations based on patient characteristics, and assess the efficacy and consequences of the proposed measures to prevent, screen for, and diagnose skin cancers in this patient group,” the study investigators commented.

From 2010 to 2020, a retrospective analysis of 564 patients with polycythemia vera or myelofibrosis from Stanford Medical Center was conducted. All patients were matched according to race, gender, age, disease diagnosis, Charlson Comorbidity Index, and follow-up time. Patients had been taking ruxolitinib for at least 4 weeks (n = 188) or had no exposure to the drug (n = 376).

The study authors reported an adjusted non-melanoma skin cancer hazard ratio of 2.69 in patients with polycythemia vera or myelofibrosis on ruxolitinib therapy. Squamous cell carcinoma was positively associated with ruxolitinib exposure (hazard ratio [HR] = 3.24). In addition, all non-melanoma skin cancers occurred in patients who were White or of an unknown race. Moreover, patients with non-JAK2 mutations had an increased risk of squamous cell carcinoma (HR = 7.40) and non-melanoma skin cancer (HR = 5.65). However, when the investigators stratified the patient population based on disease, the risk in patients with myelofibrosis was no longer significant.

Disclosure: For full disclosures of the study authors, visit jaad.org.


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