Thromboembolic toxicity observed with concurrent trametinib and lenalidomide therapy

Pediatr Blood Cancer. 2023 Mar;70(3):e30190. doi: 10.1002/pbc.30190. Epub 2023 Jan 5.

Abstract

The event-free survival of pediatric low-grade gliomas is poor, and patients often require multiple treatment strategies. While MEK and RAF inhibitors are efficacious in early-phase trials, not all patients respond, and many experience progression following completion of therapy. Evaluating combination therapies that may enhance efficacy or prolong disease stabilization is warranted. We report our institutional experience using concurrent trametinib and lenalidomide in the treatment of primary pediatric central and peripheral nervous system tumors. Two of four patients using this combination therapy experienced severe thromboembolic events, necessitating discontinuation of therapy. This combination requires further investigation, and we urge caution if used.

Keywords: lenalidomide; thromboembolic toxicity; trametinib.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Child
  • Humans
  • Lenalidomide / adverse effects
  • Proto-Oncogene Proteins B-raf
  • Pyridones* / adverse effects
  • Pyrimidinones* / adverse effects

Substances

  • Lenalidomide
  • trametinib
  • Pyridones
  • Pyrimidinones
  • Proto-Oncogene Proteins B-raf