title: Use of vemurafenib in a patient unable to swallow whole.
abstract: The treatment landscape for metastatic melanoma has increased dramatically in the past five years, with the pivotal discovery of activating BRAF mutations in half of all melanomas spurring the development for effective treatments that target mitogen-activated protein kinase (RAS/RAF/MEK/ERK) pathway. Vemurafenib, a selective mutant BRAF Val600 inhibitor, results in striking tumour responses and a survival advantage over conventional chemotherapy. We present here the case of a 38-year-old woman with metastatic BRAFV600E mutant melanoma and a severe tablet phobia, who was found to have been crushing and/or chewing her vemurafenib tablets. In this case, she attained a partial response and significant clinical benefit, albeit temporarily.
authors: Pharmacy Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia brett.janson@petermac.org.
authors: Brett
authors: B
authors: Janson
authors: Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors: James
authors: J
authors: Whittle
authors: Pharmacy Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors: Kate
authors: K
authors: Witney
authors: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors: Kate
authors: K
authors: Moodie
authors: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors: Jason
authors: J
authors: Callahan
authors: Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors: Shahneen
authors: S
authors: Sandhu
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage* / Q000627:therapeutic use; D055118:Medication Adherence; D008545:Melanoma / Q000188:drug therapy*; D009362:Neoplasm Metastasis; D013449:Sulfonamides / Q000008:administration & dosage* / Q000627:therapeutic use; D013607:Tablets; D000077484:Vemurafenib
chemical_list: D007211:Indoles; D013449:Sulfonamides; D013607:Tablets; D000077484:Vemurafenib
keywords: Vemurafenib; melanoma; swallowing tablet crushing