The potential role of phosphodiesterase type 5 inhibitors (PDE5-Is) sildenafil (Viagra®), vardenafil (Levitra®), and tadalafil (Cialis®) in development of malignant melanoma is controversial. Four observational studies have examined the association of PDE5-Is) and melanoma (1-4). While a conclusion regarding causality is challenging, the biological basis for an association between PDE5-I exposure and melanoma remains compelling. Melanoma lines expressing the BRAF oncogene downregulate PDE5, leading to vasodilation, invasion and metastasis of melanoma cells (5).
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