Hepatic hemorrhage as a consequence of rapid response to combined targeted therapy in metastatic melanoma.
A middle-aged female with metastatic melanoma was found to have hemoperitoneum after starting systemic therapy with the BRAF and MEK inhibitors dabrafenib and trametinib. Etiology proved to be bleeding from a known hepatic metastasis. The patient was managed conservatively and eventually resumed systemic therapy with ongoing response. This case serves to illustrate the possible deleterious effects of rapid tumor response after initiation of targeted systemic therapy in patients with metastatic melanoma.
Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California.
Devin C
DC
Flaherty
The Angeles Clinic and Research Institute, Los Angeles, California.
Brianna W
BW
Hoffner
Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California.
Briana J
BJ
Lau
Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California.|The Angeles Clinic and Research Institute, Los Angeles, California.
Omid
O
Hamid
Division of Surgical Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California.
Mark B
MB
Faries
D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D010091:Oximes / Q000009:adverse effects*; D011728:Pyridones / Q000009:adverse effects*; D011744:Pyrimidinones / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology
D000970:Antineoplastic Agents; D007093:Imidazoles; D010091:Oximes; D011728:Pyridones; D011744:Pyrimidinones; C560077:trametinib; C561627:dabrafenib
BRAF; MEK; dabrafenib; trametinib