If your melanoma is shown to have a BRAF mutation when it is sent for genetic testing, then targeted therapy with a BRAF inhibitor drug is a suitable option for you.  Approximately 40% patients are found to have this mutation.  BRAF inhibitor drugs have not been shown to work unless you have a BRAF mutation. A BRAF inhibitor (dabrafenib/vemurafenib/encorafenib) is usually given in combination with a MEK (another building block) inhibitor drug (trametinib/cobimetinib/binimetinib).  They are both protein inhibitors that target tumour growth pathways, slowing down cell growth and division, thereby blocking the growth and the spread of the melanoma.  They are tablets or capsules which are taken daily.

Dabrafenib + Trametinib

What is it?

  • Dabrafenib and Trametinib used in combination form a double blockade and the combination of the two inhibitors (BRAF inhibitor and MEK inhibitor) has shown significantly improved survival.Dabrafenib + Trametinib taken orally with a recommended dose and schedule of Dabrafenib 150 mg (2 of 75 mg capsules) twice daily with Trametinib 2 mg tablet once daily.
  • For stage III disease, adjuvant treatment is given for 1 year or unless unacceptable side effects occur.
  • For unresectable stage III and stage IV disease, the treatment will be continued until the treatment doesn’t work or unacceptable side effects occur.

Your doctor will discuss with you the probabilities of treatments working and the potential side effects.  More information on dabrafenib and trametinib, including potential side effects, can be found here

Risks and side effects

All cancer drug therapies are associated with some side effects that may impact on daily life to a lesser or greater extent.

The most common side effects associated with dabrafenib include skin dryness, soreness or itching, headaches, feeling sick, diarrhoea, loss of appetite, loss of energy, fever, joint pain and light sensitivity.  More information on dabrafenib, including potential side effects, can be found here.

The most common side effects associated with trametinib include rashes, diarrhoea, tiredness, feeling sick, joint pains, swelling of the ankles and feet and skin problems.  More information on Trametinib, including potential side effects can be found here

Vemurafenib + Cobimetinib (Licensed for unresectable stage III and stage IV patients only, but not routinely available in the UK)

What is it?

  • Vemurafenib is BRAF inhibitor. It is an oral drug. Patients receive 960mg (four 240 mg tablets) twice daily.
  • Cobimetinib is a MEK inhibitor and is also an oral drug and patients receive 60 mg (three 20 mg tablets) once daily for the first 21 days of each 28-day cycle until disease progression or unacceptable toxicity.

Your doctor will discuss with you the probabilities of treatments working and the potential side effects.

Risks and side effects

All cancer drug therapies are associated with some side effects that may impact on daily life to a lesser or greater extent.

The most common side effects associated with vemurafenib include fever, loss of appetite, headaches and dizziness, taste changes, cough, diarrhoea, taste changes, feeling sick, skin problems, redness and pain on the soles of the hands/feet, hair-loss, tiredness and swelling of the ankles and feet.  More information on vemurafenib, including potential side effects can be found here

The most common side effects associated with cobimetinib include diarrhoea, skin problems including sensitivity to light, feeling sick, fever, abnormal blood tests, skin problems, bleeding, eye problems and heart problems.  More information on cobimetinib, including potential side effects can be found here

Encorafenib and Binimetinib

What is it?

Encorafenib and binimetinib are available for unresectable stage III or stage IV patients with the BRAF mutation.

Encorafenib 450 mg (six 75 mg capsules) is taken once daily, when used in combination with binimetinib 45 mg (three 15 mg tablets) twice daily, corresponding to a total daily dose of 90 mg.  The treatment will be continued until the treatment doesn’t work or unacceptable side effects occur.

Your doctor will discuss with you the probabilities of treatments working and the potential side effects.

Risks and side effects

All cancer drug therapies are associated with some side effects that may impact on daily life to a lesser or greater extent.

The most common side effects associated with encorafenib include tiredness, feeling sick, skin problems, redness and pain on the hands and feet, muscle problems, difficulty sleeping, taste changes, headache, hair thinning, heart problems and abnormal blood test results.

The most common side effects associated with binimetinib include tingling in hands and feet, headaches, dizziness, bleeding, vision problems, feeling or being sick, skin problems, fever, swelling of the feet and ankles, abnormal blood tests, changes in taste, heart problems, muscle problems and increased sensitivity to sunlight.

More information on encorafenib and binimetinib, including potential side effects can be found here

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