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January 10, 2023
Dabrafenib in Combination with Trametinib Approved for Unresectable or Metastatic Tumors with BRAF V600E Mutation The combination of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib is approved for the treatment of adult and pediatric patients over the age of 6 years with unresectable or metastatic solid tumors with BRAF V600E mutation who have progressed following prior treatment. The combination was evaluated in multiple studies enrolling a total of 131 adult patients and 36 pediatric patients with objective response observed in 54% of adult patients and an overall response rate of 25% in pediatric patients. Common adverse events in adult patients included pyrexia, fatigue, nausea, rash, chills, headache, hemorrhage, cough, vomiting, constipation, diarrhea, myalgia, arthralgia and edema. Similar adverse events were observed in pediatric patients with notable additions of dry skin, dermatitis acneiform, abdominal pain and paronychia.
Upon completion of the chapter, the reader will be able to:
Describe the etiology of cancer.
Define the tumor, nodes, metastases (TNM) system of cancer staging.
Classify each drug used in the treatment of cancer and compare and contrast the mechanisms of action, uses, and adverse effects.
Outline actions for all healthcare professionals to prevent medication errors with cancer treatments.
Describe what cancer survivorship means and how this impacts future healthcare needs of an individual.
The word cancer covers a diverse array of tumor types that affect a significant number of Americans and individuals worldwide and are a major cause of mortality. The term cancer actually refers to more than 100 different diseases. What is common to all cancers is that the cancerous cell is uncontrollably growing and has the potential for invading local tissue and spreading to other parts of the body, a process called metastases. Cancer is the second leading cause of death behind heart disease.1 In 2021, it was projected that nearly 1.9 million Americans will be diagnosed with cancer, and that an estimated 608,570 Americans will die from cancer.1 Figure 88–1 describes cancers by gender, new cases, and deaths.
Cancer incidences (top) and deaths (bottom) in the United States for males and females—2020 estimates. (Reproduced, with permission, from American Cancer Society. Cancer Facts and Figures 2020. Atlanta, GA: American Cancer Society, Inc.)
Once diagnosed, a cancer patient may encounter many different healthcare professionals. All healthcare professionals must collaborate to ensure safe and appropriate prescribing, preparation, administration, and monitoring of anticancer agents; management of toxicities; resolution of reimbursement issues; and participation in clinical trials. The pharmacist is a pivotal member of the care team because of their medication expertise.2,3