Homan Morgan, Warrier Govind, Lao Christopher D, Yentz Sarah, Kraft Shawna, Fecher Leslie A
Department of Pharmacy, University of Michigan, Ann Arbor, MI, United States.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.
Front Oncol. 2022 Sep 23;12:855794. doi: 10.3389/fonc.2022.855794. eCollection 2022.
Combination dabrafenib (D) and trametinib (T) is an FDA approved adjuvant therapy for patients with resected stage III BRAF-mutant melanoma. We describe treatment-related toxicities with adjuvant D+T in a real-world population through a retrospective case series. The primary endpoint was development of toxicities.
Eighteen of the 20 patients (90%) required at least one treatment interruption due to adverse events (AEs), 11 patients (55%) required a dose reduction and 13 (65%) permanently discontinued therapy due to an AE. The nine patients who did not require dose reduction had been initiated on a lower starting dose of dabrafenib. The most common treatment-limiting AEs were recurrent pyrexia and chills (85%) and liver laboratory abnormalities (50%). The median total time on therapy was 148.5 days (range 19-383), 40.7% (range 5.2-100%) of the intended one-year duration.
Adjuvant treatment of melanoma with combination D+T is associated with treatment-limiting toxicities in the majority of this patient group. Patients should be carefully monitored throughout therapy.
达拉非尼(D)和曲美替尼(T)联合用药是美国食品药品监督管理局(FDA)批准的用于已切除的III期BRAF突变型黑色素瘤患者的辅助治疗方法。我们通过一项回顾性病例系列研究,描述了在真实世界人群中辅助性D+T治疗相关的毒性反应。主要终点是毒性反应的发生情况。
20例患者中有18例(90%)因不良事件(AE)至少需要中断一次治疗,11例患者(55%)需要降低剂量,13例(65%)因AE永久停止治疗。9例不需要降低剂量的患者开始使用的达拉非尼起始剂量较低。最常见的限制治疗的AE是反复发热和寒战(85%)以及肝脏实验室检查异常(50%)。治疗的中位总时间为148.5天(范围19 - 383天),占预期一年疗程的40.7%(范围5.2 - 100%)。
在该患者群体的大多数中,黑色素瘤辅助治疗使用D+T联合用药与限制治疗的毒性反应相关。在整个治疗过程中应仔细监测患者。