Management of Side Effects After Dabrafenib-trametinib Combination Therapy in Metastatic BRAF Mutant Melanoma: Two Case Reports with a Brief Literature Review

Öz

Malignant melanoma is an aggressive cancer type resistant to standart chemotherapy regimens in the metastatic stage. A new era has begun in the treatment of metastatic melanoma with BRAF-MEK inhibitors, which were used after the discovery of the MAP kinase signal pathway in the development of melanoma. However during the use of these drugs, a number of side effects can be observed, resulting with dose reduction and interruption or discontinuation. Drug-related side effects require a quick approach and management so that patients can benefit optimally from treatment. In this report, two patients with metastatic melanoma were evaluated, of whom one of them with pyrexia, pneumonitis noduler erythematous eruption and the other with neutropenia/ leukopenia and pyrexia due to BRAF-MEK inhibitors and clinical management of these side effects were reviewed.

Anahtar Kelimeler

• malignant melanoma,BRAF-MEK inhibitor,side effects,pyrexia

BRAF Mutant Metastatik Melanomda Dabrafenib-trametinib Kombinasyon Tedavisi Sonrası Gelişen Yan Etki Yönetimi: İki Olgu Sunumuyla Birlikte Literatür Derlemesi

Öz

Malign melanom, metastatik evrede standart kemoterapi rejimlerine dirençli agresif seyirli bir kanser türüdür. MAP kinaz sinyal yolağının melanom gelişimindeki rolünün keşfinden sonra kullanılmaya başlanan BRAF-MEK inhibitörleri ile metastatik melanomun tedavisinde yeni bir döneme girilmiştir. Ancak bu ilaçların kullanımı sırasında doz redüksiyonu, ilaca ara verme ve ilaç kesilmesine kadar gidebilen bir takım yan etkiler gözlenebilir. İlaç ilişkili yan etkiler, hastaların tedaviden optimal şekilde yararlanabilmeleri için hızlı bir yaklaşım ve yönetim gerektirir. Bu olgu sunumu ve kısa derlemede, BRAF-MEK inhibitörü kombinasyonu ile birinde ilaç ateşi, pnömonit, nodüler eritematöz döküntü diğerinde ise ilaç ateşi, lökopeni, nötropeni gelişen iki metastatik melanom olgusu ve gelişen yan etkilerin yönetimine yönelik klinik yaklaşım özetlendi.

Anahtar Kelimeler

• malign melanom,BRAF-MEK inhibitör,yan etki,ilaç ateşi

Kaynakça

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