{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:07:52Z","timestamp":1789729672558,"version":"4.0.1"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020337","name":"Springworks Therapeutics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020337","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neurofibromatosis type 1 (NF1) is a genetic disorder in which plexiform neurofibromas (PNs) develop in approximately 30% to 50% of affected individuals, often causing substantial morbidity. Treatment of NF1-associated PNs is challenging due to disease variability and tumor complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Observations<\/jats:title>\n                    <jats:p>In the Phase 2b ReNeu trial (NCT03962543), mirdametinib, a mitogen-activated protein kinase kinase 1\/2 (MEK) inhibitor, demonstrated efficacy and a manageable safety profile in children and adults with symptomatic PNs, achieving confirmed objective responses in 52% of children and 41% of adults, with substantial reductions in target tumor PN volume and improvements in patient- and parent proxy-reported outcomes. However, dermatologic adverse events (AEs) are common with MEK inhibitors, including mirdametinib, and can impact adherence and quality of life. While the ReNeu protocol included supportive care considerations for skin reactions associated with mirdametinib, some investigators recognized a need for more detailed guidance. The ReNeu Scientific Steering Committee, in collaboration with oncology and oncodermatology experts, developed expert-driven recommendations for the proactive management of mirdametinib-related skin AEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These strategies emphasize early recognition, individualized care, and timely intervention to help reduce the severity of mirdametinib-related skin AEs, minimize dose modifications, and support treatment continuity and long-term treatment goals. Although these recommendations were specifically developed for mirdametinib based on ReNeu trial experience, they may also provide practical guidance for managing skin AEs associated with other MEK inhibitors in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1826735","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:44:39Z","timestamp":1789728279000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Managing skin-related adverse events during mirdametinib treatment for NF1-PNs: expert guidance from the ReNeu trial"],"prefix":"10.3389","volume":"16","author":[{"given":"Angela C.","family":"Hirbe","sequence":"first","affiliation":[{"name":"Washington University School of Medicine","place":["St. Louis, MO, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan J.","family":"Anadkat","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine","place":["St. Louis, MO, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L.","family":"Boull","sequence":"additional","affiliation":[{"name":"University of Minnesota","place":["Minneapolis, MN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Moertel","sequence":"additional","affiliation":[{"name":"University of Minnesota","place":["Minneapolis, MN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Nickerson","sequence":"additional","affiliation":[{"name":"SpringWorks Therapeutics, Inc., a Healthcare Company of Merck KGaA","place":["Darmstadt, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Weber","sequence":"additional","affiliation":[{"name":"SpringWorks Therapeutics, Inc., a Healthcare Company of Merck KGaA","place":["Darmstadt, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusica","family":"Babovic-Vuksanovic","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester","place":["Rochester, MN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Gershon","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathol-011811-132441","article-title":"Pathogenesis of plexiform neurofibroma: tumor-stromal\/hematopoietic interactions in tumor progression","volume":"7","author":"Staser","year":"2012","journal-title":"Annu Rev Pathol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noac146","article-title":"Management of neurofibromatosis type 1-associated plexiform neurofibromas","volume":"24","author":"Fisher","year":"2022","journal-title":"Neuro Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.08.051","article-title":"Pediatric plexiform neurofibromas: impact on morbidity and mortality in neurofibromatosis type 1","volume":"160","author":"Prada","year":"2012","journal-title":"J Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1186\/s13023-023-02911-2","article-title":"Incidence and prevalence of neurofibromatosis type 1 and 2: a systematic review and meta-analysis","volume":"18","author":"Lee","year":"2023","journal-title":"Orphanet J Rare Dis"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-0660","article-title":"Health supervision for children with neurofibromatosis type 1","volume":"143","author":"Miller","year":"2019","journal-title":"Pediatrics"},{"key":"B6","doi-asserted-by":"publisher","first-page":"17004","DOI":"10.1038\/nrdp.2017.4","article-title":"Neurofibromatosis type 1","volume":"3","author":"Gutmann","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100223","article-title":"Novel molecular targeted therapies for patients with neurofibromatosis type 1 with inoperable plexiform neurofibromas: a comprehensive review","volume":"6","author":"Solares","year":"2021","journal-title":"ESMO Open"},{"key":"B8","article-title":"GOMEKLI\u00ae (mirdametinib) [prescribing information]","year":"2025"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/ph15080956","article-title":"Efficacy and safety of trametinib in neurofibromatosis type 1-associated plexiform neurofibroma and low-grade glioma: a systematic review and meta-analysis","volume":"15","author":"Wang","year":"2022","journal-title":"Pharm (Basel)"},{"key":"B10","article-title":"KOSELUGO\u00ae (selumetinib) capsules; for oral use. 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