title: Facing the challenges of new melanoma-targeted therapies: Treatment of severe fevers associated with dabrafenib/trametinib combination therapy.
abstract: With the emergence of new oral therapies for metastatic melanoma to the market, as well as ongoing pre-marketing trials and special access schemes, it is important to keep up to date with the side effect profiles of these medications. A common side effect associated with the BRAF inhibitor dabrafenib is severe fever symptoms such as pyrexia and rigors/chills; however, treatment options are limited. We report a patient who was debilitated by severe pyrexia and rigors caused by dabrafenib used in combination with trametinib to treat metastatic melanoma, who was treated with low-dose steroids. To our knowledge, the use of prednisolone for the treatment and prevention of further dabrafenib-associated pyrexia is not published; however, it is a low risk and low cost option that was very effective in this case.
authors.affiliation: Royal North Shore Hospital, Sydney, Australia julianlindsay1@gmail.com.
authors.forename: Julian N
authors.initials: JN
authors.lastname: Lindsay
authors.affiliation: Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Barras
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use; D016503:Drug Delivery Systems / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D008545:Melanoma / Q000175:diagnosis / Q000188:drug therapy*; D010091:Oximes / Q000008:administration & dosage / Q000009:adverse effects*; D011728:Pyridones / Q000008:administration & dosage / Q000009:adverse effects*; D011744:Pyrimidinones / Q000008:administration & dosage / Q000009:adverse effects*; D012720:Severity of Illness Index
chemical_list: D002511:Cephalosporins; D007093:Imidazoles; D010091:Oximes; D011728:Pyridones; D011744:Pyrimidinones; C560077:trametinib; D000077723:Cefepime; C561627:dabrafenib
keywords: BRAF inhibitor; Melanoma; dabrafenib; pyrexia; trametinib