Targeting MEK in vemurafenib-resistant hairy cell leukemia.

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Caeser, Rebecca 
Collord, Grace 
Yao, Wen-Qing 
Chen, Zi 
Vassiliou, George S  ORCID logo

To the editor: Hairy cell leukemia (HCL) is a chronic, incurable B cell malignancy that presents with splenomegaly, bone marrow infiltration and cytopenias(1). Long remissions are typically achieved with purine analogues such as cladribine, but most cases will relapse and require further therapy. The discovery of the BRAF V600E mutation in almost all cases of HCL(2) has led to the widespread adoption of the BRAF inhibitor vemurafenib for treatment of patients relapsing after cladribine(3-5). Impressive responses are reported; however, relapse is inevitable(5, 6) and hematologists are now faced with a growing number of patients with vemurafenib-resistant HCL. The optimal management of these patients remains unclear.

Aged, Antineoplastic Agents, Azetidines, Drug Resistance, Neoplasm, Humans, Leukemia, Hairy Cell, MAP Kinase Kinase 1, Male, Piperidines, Prognosis, Salvage Therapy, Vemurafenib
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Springer Science and Business Media LLC
Medical Research Council (MR/M008584/1)
Medical Research Council (MC_PC_12009)
D.H. was personally supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/M008584/1), G.C. by a Wellcome Trust Clinical PhD Fellowship (WT098051). W.Y. was supported by an International Collaboration Award from the Pathological Society of UK and Ireland. Research in M.D. lab was supported by grants from Bloodwise. Core support was received from the Cancer Research UK, Cambridge Cancer Centre. We thank Joanna Baxter and Cambridge Blood and Stem Cell Bank for sample collection and storage, and Calli Latimer and Claire Hardy for expert technical assistance