Cutaneous Toxicities of MEK Inhibitor Use in Children: A Comparison of Binimetinib and Selumetinib

This study investigated the cutaneous toxicities associated with the use of MEK inhibitors, binimetinib and selumetinib, in a pediatric population with neuro-oncological conditions. A retrospective review was conducted on 46 children, with 33 treated with binimetinib and 13 with selumetinib. Dermatologic adverse events were prevalent, occurring in 97.8% of the cohort, with acneiform eruption, paronychia, and xerosis being the most common. Age was a factor, with older children more likely to experience acneiform eruptions and seborrheic dermatitis, while younger children were more prone to xerosis. Notably, binimetinib was associated with a higher incidence of folliculitis and hair pigment dilution compared to selumetinib. Additionally, a greater proportion of patients on binimetinib required dose reduction or hold due to adverse events. The study concludes that while dermatologic adverse events are common with MEK inhibitors, selumetinib is associated with less severe adverse events, which can inform clinical decisions and patient counseling.