Acute encephalopathy secondary to dabrafenib and trametinib in BRAF-positive metastatic adenocarcinoma of the lung

Randhawa, Jaskirat; Onyshchenko, Mykola

doi:10.1177/1078155218790331

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…19 In addition, two case reports of non-hyperammonemic encephalopathy have been described associated with dabrafenib-trametinib combination. 20,21 Herein we report a case of a metastatic GIST with NF1 mutation that developed drug-induced hyperammonemic encephalopathy related to trametinib and regorafenib.…”

Section: Discussionmentioning

confidence: 99%

Hyperammonemic encephalopathy after tyrosine kinase inhibitors: A literature review and a case example

García-Díaz,

Eremiev,

Gómez-Alonso

et al. 2024

J Oncol Pharm Pract

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Objective To review the evidence of uncommon but fatal adverse event of hyperammonemic encephalopathy by tyrosine kinase inhibitors (TKI) and the possible mechanisms underlying this condition and to describe the case of a patient that developed drug-induced hyperammonemic encephalopathy related to TKI. Data Sources Literature search of different databases was performed for studies published from 1 January 1992 to 7 May 2023. The search terms utilized were hyperammonemic encephalopathy, TKI, apatinib, pazopanib, sunitinib, imatinib, sorafenib, regorafenib, trametinib, urea cycle regulation, sorafenib, carbamoyl-phosphate synthetase 1, ornithine transcarbamylase, argininosuccinate synthetase, argininosuccinate lyase, arginase 1, Mitogen activated protein kinases (MAPK) pathway and mTOR pathway, were used individually search or combined. Data Summary Thirty-seven articles were included. The articles primarily focused in hyperammonemic encephalopathy case reports, management of hyperammonemic encephalopathy, urea cycle regulation, autophagy, mTOR and MAPK pathways, and TKI. Conclusion Eighteen cases of hyperammonemic encephalopathy were reported in the literature from various multitargeted TKI. The mechanism of this event is not well-understood but some authors have hypothesized vascular causes since some of TKI are antiangiogenic, however our literature review shows a possible relationship between the urea cycle and the molecular inhibition exerted by TKI. More preclinical evidence is required to unveil the biochemical mechanisms responsible involved in this process and clinical studies are necessary to shed light on the prevalence, risk factors, management and prevention of this adverse event. It is important to monitor neurological symptoms and to measure ammonia levels when manifestations are detected.

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Section: Discussionmentioning

confidence: 99%

Hyperammonemic encephalopathy after tyrosine kinase inhibitors: A literature review and a case example

García-Díaz,

Eremiev,

Gómez-Alonso

et al. 2024

J Oncol Pharm Pract

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“…However, literature reports no encephalopathy incidence in patients treated by TT in second line after immunotherapy. Randhawa and al [6] reported an acute encephalopathy two weeks after TT initiation in a patient who received ICI in first metastatic line combined to chemotherapy, secondarily switched to TT. It was reversible after drug discontinuation.…”

Section: Discussionmentioning

confidence: 99%

Acute Late-Onset Diffuse Encephalopathy Secondary to Target Therapies in Metastatic Melanoma

2023

Ann Case Report

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Immunotherapy and targeted therapies are both major drugs used for metastatic melanomas. Various severe adverse event are reported with both. Few cases of acute encephalopathy induced by targeted therapies are described, resolving after discontinuation, but it rarely occurs as a late adverse event. We report a severe acute late-onset diffuse encephalopathy induced by targeted therapy (BRAF and MEK inhibitors), not resolving after treatment discontinuation and immunosuppressive treatment.

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“…These ADRs are not well documented; few case reports have been published. For instance, cases of patients with melanoma or lung cancer developing acute encephalopathy secondary to treatment with BRAFi (inducing acute confusion) 32 . A case of pneumothorax occurred shortly after nivolumab infusion and was therefore likely to be due to lymphangioleiomyomatosis 33 .…”

Section: Discussionmentioning

confidence: 99%

“…For instance, cases of patients with melanoma or lung cancer developing acute encephalopathy secondary to treatment with BRAFi (inducing acute confusion). 32 A case of pneumothorax occurred shortly after nivolumab infusion and was therefore likely to be due to lymphangioleiomyomatosis. 33 Recurrent pleural effusions in patients with lung cancer treated with nivolumab were also described.…”

Section: Discussionmentioning

confidence: 99%

Safety profile of drugs for advanced melanoma: A report based on 2008–2018 US Food and Drug Administration Data

Casarotto

Noïze

Létinier

et al. 2020

Brit J Clinical Pharma

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We describe the safety profiles of all drug classes used for the treatment of advanced melanoma from the US Food and Drug Administration Adverse Event Reporting System over 2008–2018. Adverse reactions reported in 25 900 pharmacovigilance cases are described for chemotherapies, immunomodulators, targeted therapies and immunotherapies. There was a sharp increase in the number of cases over time, with peaks associated with the launch of new treatments. The adverse reactions diversified over time; notably, skin (alopecias, dermatitis) and retinal disorders were frequently associated with targeted therapies and endocrine disorders (hypothalamus, thyroid and adrenal dysfunctions) with immunotherapies. Less well‐known reactions were also detected, such as neuropsychiatric disorders with targeted therapies and gastrointestinal ulcers, pneumothorax and pleural effusions with immunotherapies. The findings highlight the need for various health professionals (including medical specialists or trained nurses) to enhance management of complications.

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Acute encephalopathy secondary to dabrafenib and trametinib in BRAF-positive metastatic adenocarcinoma of the lung

Cited by 6 publications

References 12 publications

Hyperammonemic encephalopathy after tyrosine kinase inhibitors: A literature review and a case example

Hyperammonemic encephalopathy after tyrosine kinase inhibitors: A literature review and a case example

Acute Late-Onset Diffuse Encephalopathy Secondary to Target Therapies in Metastatic Melanoma

Safety profile of drugs for advanced melanoma: A report based on 2008–2018 US Food and Drug Administration Data

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