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Title: Optimizing combination dabrafenib and trametinib therapy in BRAF mutation-positive advanced melanoma patients: Guidelines from Australian melanoma medical oncologists.
Austin Authors: Atkinson, Victoria;Long, Georgina V;Menzies, Alexander M;McArthur, Grant;Carlino, Matteo S;Millward, Michael;Roberts-Thomson, Rachel;Brady, Benjamin;Kefford, Richard;Haydon, Andrew;Cebon, Jonathan S 
Affiliation: Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Westmead Hospital and Macquarie University, Sydney, New South Wales, Australia
The Alfred Hospital, Melbourne, Victoria, Australia
Princess Alexandra Hospital, Greenslopes Private Hospital and University of Queensland, Brisbane, Queensland, Australia
Melanoma Institute Australia, Royal North Shore and Mater Hospitals, The University of Sydney, Sydney, New South Wales, Australia
Peter MacCallum Cancer Centre and Cabrini Health, Melbourne, Victoria, Australia
Westmead Hospital, Sydney, New South Wales, Australia
School of Medicine and Pharmacology, University of Western Australia, Australia and Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
Queen Elizabeth Hospital, Adelaide, South Australia
Issue Date: Dec-2016
Publication information: Asia-Pacific journal of clinical oncology 2016; 12 Suppl 7: 5-12
Abstract: BRAF mutations occur commonly in metastatic melanomas and inhibition of mutant BRAF and the downstream kinase MEK results in rapid tumor regression and prolonged survival in patients. Combined therapy with BRAF and MEK inhibition improves response rate, progression free survival and overall survival compared with single agent BRAF inhibition, and reduces the skin toxicity that is seen with BRAF inhibitor monotherapy. However, this combination is associated with an increase in other toxicities, particularly drug-related pyrexia, which affects approximately 50% of patients treated with dabrafenib and trametinib (CombiDT). We provide guidance on managing adverse events likely to arise during treatment with combination BRAF and MEK inhibition with CombiDT: pyrexia, skin conditions, fatigue; and discuss management of CombiDT during surgery and radiotherapy. By improving tolerability and in particular preventing unnecessary treatment cessations or reduction in drug exposure, best outcomes can be achieved for patients undergoing CombiDT therapy.
DOI: 10.1111/ajco.12656
ORCID: 0000-0002-3898-950X
Journal: Asia-Pacific journal of clinical oncology
PubMed URL: 27905182
Type: Journal Article
Subjects: BRAF
Appears in Collections:Journal articles

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