- A new report summarizes the toxicity profile of dabrafenib plus trametinib combination therapy for BRAF V600E-positive NSCLC and guidelines for adverse event (AE) management.
Why this matters
- This combination therapy was approved for BRAF V600E-positive metastatic melanoma in 2014 but has only been approved in NSCLC patients since 2017.
- Pyrexia is the most common AE.
- Dabrafenib may be discontinued with fever of 38.5-40°C and resumed when fever resolves at the same or lower dose.
- Discontinue both drugs if fever is >40°C or if fever includes rigors, hypotension, dehydration, or renal failure until fever resolves and resume at a lower dose or discontinue.
- Complete a dermatological exam before treatment initiation, every 2 months during treatment, and for up to 6 months following cessation.
- Dabrafenib may increase risk of new skin cancers.
- Dermatitis acneiform is the most common AE associated with trametinib but its incidence is attenuated when combined with dabrafenib.
- Blurred vision, retinal detachment, retinal vein occlusion, chorioretinopathy, uveitis, and iritis are some of the ocular toxicities reported.
- Left ventricular ejection fraction function should be assessed before treatment onset, 1 month after initiation, and every 2-3 months during treatment.
- Hemorrhages are also possible.