LETTER TO THE EDITOR: Management of Vemurafenib Induced Severe Arthralgia and Pyrexia in a Patient with BRAF V600E Mutated Melanoma: First Experience with a Switch to Dabrafenib

Abstract

The invention of targeted therapy for BRAF mutated advanced stage melanoma has given the patients the perspective of a possible longer remission of the disease based on taking several pills a day without a further hospital stay. That is the ideal situation. However, the new drugs are not without side effects. Amongst them, fever and acute arthralgia are well known. We report on a patient in which these effects were so severe under vemurafenib that we had to stop the drug twice in the induction phase. Only with concomitant administration of corticosteroids finally a third induction worked. After 6 months on this therapy we switched the patient to dabrafenib and observed that in this case dabrafenib was much better tolerated. This is the second report on such a switch between the two licensed BRAF inhibitors because of side effects so far.