Track

Clinical Studies

Abstract

Janus kinase inhibitors (JAKi) are prescribed to treat autoimmune/autoinflammatory conditions, graft-vs-host disease, and hematologic malignancies. Melanomas have been reported in patients taking JAKi, but the clinical and histopathological details are poorly understood. The JAK-STAT pathway plays a critical role in anti-cancer immunity; JAKi may influence melanoma pathogenesis. Patients diagnosed with melanoma after initiating JAKi therapy from 1/1/2010-4/1/2024 were identified using the patient data registry at two academic hospitals. Sixteen patients met inclusion criteria, including ten females, with a mean age of 65.1 +/- 11.3 years (range: 36-79 years). Mean time from JAKi initiation to melanoma diagnosis was 2.3 +/- 1.8 years. There were fifteen cases of primary cutaneous melanoma; five were melanoma in situ and ten were invasive melanoma involving the extremities (n=9), trunk (n=3), face (n=2), and scalp (n=1). Eleven cases (73%) represented a first-time melanoma diagnosis. Nine melanomas (60%) presented with thickness >0.8 mm and four (27%) with ulceration. Lymph node metastases were identified in one patient, and another had local recurrence following initial treatment. Of three patients with a prior history of melanoma, one developed brain metastases and two others had local recurrences after starting JAKi therapy. We report a case series of melanoma in the setting of JAKi therapy. These data highlight potential adverse effects of JAKi therapy, including melanoma with poor prognostic features. Patients on JAKi should be routinely screened for skin cancer, including melanoma. Careful consideration is warranted prior to initiating JAKi therapy in patients with a history of melanoma.