ReviewInternational journal of radiation oncology, biology, physics2016
Avoiding Severe Toxicity From Combined BRAF Inhibitor and Radiation Treatment: Consensus Guidelines from the Eastern Cooperative Oncology Group (ECOG).
Review in International journal of radiation oncology, biology, physics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 67 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 1 synthesis or guideline pooled it, 158 citations in OpenAlex.
- Safety of radiosurgery concurrent with systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy) in brain metastases: a systematic review.Cancer metastasis reviews · 2021Pooled it
- Single institutional outcomes of whole brain radiotherapy for metastatic melanoma brain metastases.Radiation oncology (London, England) · 2021Trial
- Practical management of BRAF inhibitors in glioma: toxicity and resistance.CNS oncology · 2026Review
- Integrated approaches to sensitizing melanoma to radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Review
- The role of radiotherapy in patients with advanced melanoma failing targeted therapy.Acta oncologica (Stockholm, Sweden) · 2026Article
- Scalp Melanoma in a Young Patient With Systemic Sarcoidosis: Multidisciplinary Approach.Clinical case reports · 2026Article
- Chronic radiation-induced dermatitis: what is new in 2024? A narrative review.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026Review
- Impact of RAS-MAPK Pathway Genetic Alterations on Radiotherapy Response in Metastatic Lung Adenocarcinoma.JCO precision oncology · 2025Article
- Exploratory Advanced Radiotherapies for Ameloblastoma and Ameloblastic Carcinoma-A Concise Review.Oral diseases · 2025Review
- Synchronous Melanoma and Follicular Lymphoma in the Same Nodal Basin: A Diagnostic and Therapeutic Challenge.Cancer reports (Hoboken, N.J.) · 2025Article
- Stereotactic body radiotherapy combined with immunotherapy or targeted therapy: a screenshot from Italy on behalf of the Italian Association of Clinical Oncology and Radiotherapy (AIRO).La Radiologia medica · 2025Article
- Radiation and Melanoma: Where Are We Now?Current oncology reports · 2024Review
- Canadian Consensus for Treatment of BRAFCurrent oncology (Toronto, Ont.) · 2024Article
- A topical BRAF inhibitor (LUT-014) for treatment of radiodermatitis among women with breast cancer.JAAD international · 2024Article
- Diagnostic and Therapeutic Particularities of Symptomatic Melanoma Brain Metastases from Case Report to Literature Review.Diagnostics (Basel, Switzerland) · 2024Article
- Entero-Cutaneous and Entero-Atmospheric Fistulas: Insights into Management Using Negative Pressure Wound Therapy.Journal of clinical medicine · 2024Review
- Very early symptomatic metastasis pseudoprogression after stereotactic brain radiosurgery in a melanoma patient treated with BRAF/MEK inhibitors: a case report and review of the literature.Frontiers in oncology · 2024Article
- Intraoperative or postoperative stereotactic radiotherapy for brain metastases: time to systemic treatment onset and other patient-relevant outcomes.Journal of neuro-oncology · 2023Article
- Diagnosis and management of complications from the treatment of primary central nervous system tumors in adults.Neuro-oncology · 2023Article
- Surgical complications of oncological treatments: A narrative review.World journal of gastrointestinal surgery · 2023Review
7 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
BRAF kinase gene V600 point mutations drive approximately 40% to 50% of all melanomas, and BRAF inhibitors (BRAFi) have been found to significantly improve survival outcomes. Although radiation therapy (RT) provides effective symptom palliation, there is a lack of toxicity and efficacy data when RT is combined with BRAFi, including vemurafenib and dabrafenib. This literature review provides a detailed analysis of potential increased dermatologic, pulmonary, neurologic, hepatic, esophageal, and bowel toxicity from the combination of BRAFi and RT for melanoma patients described in 27 publications. Despite 7 publications noting potential intracranial neurotoxicity, the rates of radionecrosis and hemorrhage from whole brain RT (WBRT), stereotactic radiosurgery (SRS), or both do not appear increased with concurrent or sequential administration of BRAFis. Almost all grade 3 dermatitis reactions occurred when RT and BRAFi were administered concurrently. Painful, disfiguring nondermatitis cutaneous reactions have been described from concurrent or sequential RT and BRAFi administration, which improved with topical steroids and time. Visceral toxicity has been reported with RT and BRAFi, with deaths possibly related to bowel perforation and liver hemorrhage. Increased severity of radiation pneumonitis with BRAFi is rare, but more concerning was a potentially related fatal pulmonary hemorrhage. Conversely, encouraging reports have described patients with leptomeningeal spread and unresectable lymphadenopathy rendered disease free from combined RT and BRAFi. Based on our review, the authors recommend holding BRAFi and/or MEK inhibitors ≥3 days before and after fractionated RT and ≥1 day before and after SRS. No fatal reactions have been described with a dose <4 Gy per fraction, and time off systemic treatment should be minimized. Future prospective data will serve to refine these recommendations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.