Open AccessEmpiric Therapy with BRAF and MEK Inhibitors in Metastatic Melanoma
Author(s) -
Cann Christopher G.,
Tillman Benjamin F.,
Davis Elizabeth J.,
Johnson Douglas B.
Publication year - 2019
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2019-0332
Subject(s) - medicine , fulminant , metastatic melanoma , melanoma , empiric treatment , mek inhibitor , empiric therapy , vemurafenib , mutation , oncology , cancer research , pathology , mapk/erk pathway , biochemistry , chemistry , alternative medicine , kinase , gene , microbiology and biotechnology , biology , antibiotics
BRAF and MEK inhibitors are highly active in the setting of BRAF V600 mutant melanoma. Rarely, patients without previous testing present with fulminant progression necessitating emergent treatment prior to BRAF testing results. The safety and efficacy of empiric treatment in this setting is unclear. Herein, we present two patients treated with empiric BRAF and MEK inhibitors, resulting in dramatic clinical improvement in one patient later found to have a BRAF mutation, and lack of improvement (but no accelerated progression) in a patient lacking this mutation. Empiric BRAF and MEK inhibitor treatment should not be routinely pursued but may be given safely in rare, emergent situations.