Dabrafenib and trametinib induced pancreatitis: a case report and review of the literature

Anticancer Drugs. 2021 Feb 1;32(2):215-217. doi: 10.1097/CAD.0000000000001009.

Abstract

Approximately 50% of melanomas are characterized by BRAF mutation (V600E in 90% of cases), that predicts more aggressive behaviour. This mutation is the target of dabrafenib, an anti-BRAF tyrosine-kinase inhibitor (TKI), that together with trametinib, anti-MEK TKI, is approved for first-line treatment of metastatic melanoma due to significant benefit in overall and progression-free survival. Most common treatment-related adverse events are pyrexia, chills, fatigue, rash, nausea, vomiting, and diarrhoea. This case report aims to present another less common adverse event of combined anti-BRAF and anti-MEK treatment. Our patient, after 4 months on target-therapy, experienced sudden deep abdominal pain. At the initial work-out at the emergency department, increase in serum lipase was detected and radiological findings were consistent with acute pancreatitis. Admitted to the hospital, other causes were ruled out and target-therapy was discontinued with symptoms improvement. Radiological and clinical follow-up was performed and a diagnosis of drug-induced pancreatitis was made. After few days of medical support with analgesia and antibiotic, the patient felt better and was discharged; target-therapy was permanently interrupted. Searching the literature, not so many cases of iatrogenic pancreatitis are described with this TKI combination, therefore, we have reported it as a rare but life-threatening adverse event that should be investigated whenever conceivable.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Humans
  • Imidazoles / adverse effects*
  • Imidazoles / therapeutic use
  • Male
  • Melanoma / drug therapy
  • Melanoma / pathology
  • Neoplasm Metastasis
  • Oximes / adverse effects*
  • Oximes / therapeutic use
  • Pancreatitis / chemically induced*
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*
  • Pyridones / adverse effects*
  • Pyridones / therapeutic use
  • Pyrimidinones / adverse effects*
  • Pyrimidinones / therapeutic use
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology

Substances

  • Imidazoles
  • Oximes
  • Pyridones
  • Pyrimidinones
  • trametinib
  • Proto-Oncogene Proteins B-raf
  • dabrafenib