Progression of RAS-mutant leukemia during RAF inhibitor treatment Academic Article uri icon


MeSH Major

  • Genes, ras
  • Indoles
  • Leukemia, Myelomonocytic, Chronic
  • Melanoma
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins B-raf
  • Sulfonamides


  • 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.

publication date

  • December 13, 2012



  • Academic Article



  • eng

PubMed Central ID

  • PMC3627494

Digital Object Identifier (DOI)

  • 10.1056/NEJMoa1208958

PubMed ID

  • 23134356

Additional Document Info

start page

  • 2316

end page

  • 21


  • 367


  • 24