Successful Dabrafenib Desensitization Protocols in a Patient with Metastatic Melanoma. 2022

Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
Department of Allergology "Carol Davila", University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Dabrafenib and trametinib are two available molecules that have been approved for the treatment of metastatic melanoma with BRAF-V600E or V600K mutations. Their combined therapy has led to long-lasting survival benefits and substantially improved outcomes. Until now, only a few cases of severe hypersensitivity reactions to dabrafenib and vemurafenib have been reported, and even fewer desensitization protocols to these molecules have been documented. We report the case of a 71-year-old female patient with metastatic melanoma harboring a BRAF-V600E mutation undergoing targeted therapy with dabrafenib and trametinib. Two weeks after the initiation of the combined treatment, she developed a hypersensitivity reaction. The cause-effect relationship between dabrafenib and the hypersensitivity reaction was demonstrated twice, when symptoms recurred upon dabrafenib reintroduction. We started a rapid 3-day dabrafenib desensitization protocol, which was well tolerated. When the patient discontinued the drug administration, we decided on a longer protocol that included more steps and more days in order to prevent the occurrence of other hypersensitivity reactions. Our patient tolerated both rapid and slow-going schedules, the first one reaching the final dose within 3 days and the second one reaching the total daily dose within 14 days. Depending on the patient's needs, the severity of the hypersensitivity reaction and the hospital's availability, the doctor may choose either the rapid or slow-going desensitization protocol.

UI MeSH Term Description Entries
D007093 Imidazoles Compounds containing 1,3-diazole, a five membered aromatic ring containing two nitrogen atoms separated by one of the carbons. Chemically reduced ones include IMIDAZOLINES and IMIDAZOLIDINES. Distinguish from 1,2-diazole (PYRAZOLES).
D008545 Melanoma A malignant neoplasm derived from cells that are capable of forming melanin, which may occur in the skin of any part of the body, in the eye, or, rarely, in the mucous membranes of the genitalia, anus, oral cavity, or other sites. It occurs mostly in adults and may originate de novo or from a pigmented nevus or malignant lentigo. Melanomas frequently metastasize widely, and the regional lymph nodes, liver, lungs, and brain are likely to be involved. The incidence of malignant skin melanomas is rising rapidly in all parts of the world. (Stedman, 25th ed; from Rook et al., Textbook of Dermatology, 4th ed, p2445) Malignant Melanoma,Malignant Melanomas,Melanoma, Malignant,Melanomas,Melanomas, Malignant
D009154 Mutation Any detectable and heritable change in the genetic material that causes a change in the GENOTYPE and which is transmitted to daughter cells and to succeeding generations. Mutations
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D010091 Oximes Compounds that contain the radical R2C Aldoximes,Hydroxyimino Compounds,Ketoxime,Ketoximes,Oxime,Compounds, Hydroxyimino
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000971 Antineoplastic Combined Chemotherapy Protocols The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form. Anticancer Drug Combinations,Antineoplastic Agents, Combined,Antineoplastic Chemotherapy Protocols,Antineoplastic Drug Combinations,Cancer Chemotherapy Protocols,Chemotherapy Protocols, Antineoplastic,Drug Combinations, Antineoplastic,Antineoplastic Combined Chemotherapy Regimens,Combined Antineoplastic Agents,Agent, Combined Antineoplastic,Agents, Combined Antineoplastic,Anticancer Drug Combination,Antineoplastic Agent, Combined,Antineoplastic Chemotherapy Protocol,Antineoplastic Drug Combination,Cancer Chemotherapy Protocol,Chemotherapy Protocol, Antineoplastic,Chemotherapy Protocol, Cancer,Chemotherapy Protocols, Cancer,Combinations, Antineoplastic Drug,Combined Antineoplastic Agent,Drug Combination, Anticancer,Drug Combination, Antineoplastic,Drug Combinations, Anticancer,Protocol, Antineoplastic Chemotherapy,Protocol, Cancer Chemotherapy,Protocols, Antineoplastic Chemotherapy,Protocols, Cancer Chemotherapy
D012878 Skin Neoplasms Tumors or cancer of the SKIN. Cancer of Skin,Skin Cancer,Cancer of the Skin,Neoplasms, Skin,Cancer, Skin,Cancers, Skin,Neoplasm, Skin,Skin Cancers,Skin Neoplasm

Related Publications

Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
September 2015, Japanese journal of clinical oncology,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
August 2021, Melanoma research,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
October 2018, JAAD case reports,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
January 2017, Pigment cell & melanoma research,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
March 2021, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
October 2014, Melanoma research,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
June 2016, Journal of medical case reports,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
August 2015, The American Journal of dermatopathology,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
April 2014, Melanoma research,
Roxana Silvia Bumbacea, and Selda Ali, and Sabina Loredana Corcea, and Dan Corneliu Jinga, and Luiza Spiru
October 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
Copied contents to your clipboard!