Relatively mild symptoms after chronic overdose with a double-dose encorafenib: a case report

• Published in: Anti-cancer drugs Vol. 32; no. 5; p. 589
• Main Authors: Mian, Paola, Meussen, Elvera, Piersma, Djura, Lankheet, Nienke A G
• Format: Journal Article
• Language: English
• Published: England 01.06.2021
• Subjects: Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Agents - blood; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Benzimidazoles - administration & dosage; Benzimidazoles - adverse effects; Carbamates - administration & dosage; Carbamates - adverse effects; Carbamates - blood; Communicable Disease Control; COVID-19 - epidemiology; Dose-Response Relationship, Drug; Drug Monitoring - methods; Drug Overdose - blood; Drug Overdose - diagnosis; Drug Overdose - etiology; Drug Overdose - physiopathology; Humans; Liver Function Tests - methods; Long QT Syndrome - chemically induced; Long QT Syndrome - diagnosis; Male; Medication Therapy Management - standards; Melanoma - drug therapy; Melanoma - genetics; Melanoma - pathology; Middle Aged; Mutation; Proto-Oncogene Proteins B-raf - antagonists & inhibitors; Proto-Oncogene Proteins B-raf - genetics; Skin Neoplasms - drug therapy; Skin Neoplasms - genetics; Skin Neoplasms - pathology; Sulfonamides - administration & dosage; Sulfonamides - adverse effects; Sulfonamides - blood; Vomiting - chemically induced; Vomiting - diagnosis
• ISSN: 1473-5741
• DOI: 10.1097/CAD.0000000000001052

Encorafenib (Braftovi) is indicated for the treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation, in combination with binimetinib (Mektovi). According to the product label of encorafenib, there are no specific treatment recommendations in case of an overdose. We report on a 63-year-old man who ingested a double dose (900 mg) of encorafenib for 16 days. He developed overall minor chronic overdose symptoms such as nausea and vomiting grade 1 and muscle pain. Based on the most occurring adverse events of encorafenib, liver values, kidney function parameters and QTc interval were measured. Kidney function parameters were normal, whereas liver values were slightly increased (grade 1) and QTc slightly prolonged. The plasma concentration 3 h after the last dose was 2110 ng/mL. We describe the course of a case with a chronic overdose during 16 days of the double dose of encorafenib as well as the followed approach, which could be taken into account when observing an encorafenib overdose. Providing information in times of Covid-19 is challenging, but remains necessary for good clinical care.