[HTML][HTML] Immunomodulatory Properties of BRAF and MEK Inhibitors Used for Melanoma Therapy—Paradoxical ERK Activation and Beyond

T Jung, M Haist, M Kuske, S Grabbe… - International Journal of …, 2021 - mdpi.com
T Jung, M Haist, M Kuske, S Grabbe, M Bros
International Journal of Molecular Sciences, 2021mdpi.com
The advent of mitogen-activated protein kinase (MAPK) inhibitors that directly inhibit tumor
growth and of immune checkpoint inhibitors (ICI) that boost effector T cell responses have
strongly improved the treatment of metastatic melanoma. In about half of all melanoma
patients, tumor growth is driven by gain-of-function mutations of BRAF (v-rat fibrosarcoma
(Raf) murine sarcoma viral oncogene homolog B), which results in constitutive ERK
activation. Patients with a BRAF mutation are regularly treated with a combination of BRAF …
The advent of mitogen-activated protein kinase (MAPK) inhibitors that directly inhibit tumor growth and of immune checkpoint inhibitors (ICI) that boost effector T cell responses have strongly improved the treatment of metastatic melanoma. In about half of all melanoma patients, tumor growth is driven by gain-of-function mutations of BRAF (v-rat fibrosarcoma (Raf) murine sarcoma viral oncogene homolog B), which results in constitutive ERK activation. Patients with a BRAF mutation are regularly treated with a combination of BRAF and MEK (MAPK/ERK kinase) inhibitors. Next to the antiproliferative effects of BRAF/MEKi, accumulating preclinical evidence suggests that BRAF/MEKi exert immunomodulatory functions such as paradoxical ERK activation as well as additional effects in non-tumor cells. In this review, we present the current knowledge on the immunomodulatory functions of BRAF/MEKi as well as the non-intended effects of ICI and discuss the potential synergistic effects of ICI and MAPK inhibitors in melanoma treatment.
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