Long-term tolerability of the BRAF inhibitor vemurafenib in patients with metastatic melanoma: current study data and real-life observations

• Published in: Memo - Magazine of European medical oncology Vol. 7; no. 3; pp. 181 - 186
• Main Authors: Balmelli, Cathrin, Mark, Michael, Spirig, Christian, Spataro, Vito, Pederiva, Stefanie, Monnerat, Christian, Zippelius, Alfred, Wicki, Andreas
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.09.2014
• Subjects: Medicine; Medicine & Public Health; Oncology; Special Report; Melanoma/drug therapy; Antineoplastic agents/adverse effects; Proto-oncogene proteins BRAF/antagonists & inhibitors; Vemurafenib/Zelboraf; Antineoplastic agents/therapeutic use
• ISSN: 1865-5041; 1865-5076
• DOI: 10.1007/s12254-014-0156-6

Vemurafenib is a targeted therapy against metastatic melanoma. It specifically inhibits the V600 mutated BRAF kinase in the mitogen-activated protein kinase pathway. Only limited data are available on long-term tolerability and efficacy of this drug. Here, we report and discuss six patients from our own clinical practice who were treated with vemurafenib for 16–27 months. Overall, these long-term responders tolerated vemurafenib well during the prolonged period of therapy. Most of the side-effects occurred during the first 6 months of treatment and were transient. The most common persistent side-effect was phototoxicity, which was manageable by precautionary measures or with dose reduction. Interestingly, even permanent dose reductions of 50 % of the standard dose did not abrogate long lasting remissions but improved tolerability, which is a prerequisite of long-term therapy. In addition to our own clinical experience, this article reviews current study results regarding the tolerability and efficacy of long-term vemurafenib therapy.