RESEARCH ARTICLE


LETTER TO THE EDITOR: Management of Vemurafenib Induced Severe Arthralgia and Pyrexia in a Patient with BRAF V600E Mutated Melanoma: First Experience with a Switch to Dabrafenib



Lars Alexander Schneider*, 1, Peter Paschka2, Karin Scharffetter-Kochanek1, Verena Haftek2, Nicolai Treiber1, Margit Anna Huber1
1 Skin Cancer Center Ulm, University Department of Dermatology and Allergology Ulm, Germany
2 Department of Haematology and Oncology, University of Ulm, Germany


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Creative Commons License
© Schneider et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Dermatology and Allergology, Albert-Einstein- Allee 11, D89081 Ulm, University of Ulm, D-89081 Ulm, Germany. Tel: 0049 731500-57605; Fax: 0049 731500-57666; E-mail: Lars-alexander.schneider@uni-ulm.de


Abstract

The invention of targeted therapy for BRAF mutated advanced stage melanoma has given the patients the perspective of a possible longer remission of the disease based on taking several pills a day without a further hospital stay. That is the ideal situation. However, the new drugs are not without side effects. Amongst them, fever and acute arthralgia are well known. We report on a patient in which these effects were so severe under vemurafenib that we had to stop the drug twice in the induction phase. Only with concomitant administration of corticosteroids finally a third induction worked. After 6 months on this therapy we switched the patient to dabrafenib and observed that in this case dabrafenib was much better tolerated. This is the second report on such a switch between the two licensed BRAF inhibitors because of side effects so far.

Keywords: Arthralgia, BRAF V600E, dabrafenib, fever, malignant melanoma, side effects, vemurafenib.