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Risk Stratification, Screening and Treatment of BRAF/MEK Inhibitors-Associated Cardiotoxicity

  • Isabelle Senechal,
  • Maria Sol Andres,
  • Jieli Tong,
  • Sivatharshini Ramalingam,
  • Muhummad Sohaib Nazir,
  • Stuart D. Rosen,
  • Kate Young,
  • Praveena Idaikkadar,
  • James Larkin,
  • Alexander R. Lyon

摘要

Purpose of Review

In this review article we describe the cardiovascular adverse events associated with BRAF and MEK inhibitors as well as their pathophysiologic mechanisms and provide up to date guidance for risk stratified surveillance of patients on treatment and the optimal management of emergent cardiotoxicities.

Recent Findings

Combination BRAF/MEK inhibition has become an established standard treatment option for patients with a wide variety of BRAF mutant haematological and solid organ cancers, its use is most commonly associated with stage three and metastatic melanoma. The introduction of these targeted drugs has significantly improved the prognosis of previously treatment resistant cancers.

Summary

It is increasingly recognised that these drugs have a number of cardiovascular toxicities including left ventricular systolic dysfunction, hypertension and QTc interval prolongation. Whilst cardiotoxicity is largely reversible and manageable with medical therapy, it does limit the effective use of these highly active agents.