Pierre-Yves Courand1,2, Mathilde Berger3, Anissa Bouali4, Brahim Harbaoui4,5, Pierre Lantelme4,5, Stéphane Dalle3. 1. Fédération de Cardiologie, Hôpital de La Croix-Rousse Et Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France. pierre-yves.courand@chu-lyon.fr. 2. Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France. pierre-yves.courand@chu-lyon.fr. 3. Service de Dermatologie, Hôpital de Lyon Sud, Pierre Bénite, France. 4. Fédération de Cardiologie, Hôpital de La Croix-Rousse Et Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France. 5. Université de Lyon, CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France.
Abstract
PURPOSE OF REVIEW: The identification of BRAF mutation prompted the development of new class of targeted therapy for treating melanoma: BRAF inhibitors and MEK inhibitors. Cardiovascular events have been reported with these treatments and could counterbalance their long-term maintenance. RECENT FINDINGS: LVEF decrease due to BRAF and MEK inhibitors appears fairly common (10%) but usually not severe, without impact on patient outcomes. To date, no treatment options have been tested to prevent or to treat a decrease of LVEF associated with BRAF and MEK inhibitors. QTc prolongation was observed in 3% and arterial hypertension in 20% during treatment but only one-third of cases required a therapeutic change. BRAF and MEK inhibitors have revolutionized the management and the prognosis of melanoma patients. Cardio-oncology units may be useful for a better care of potential cardiac toxicity and particularly to inappropriately avoid discontinuing BRAF and MEK inhibitors.
PURPOSE OF REVIEW: The identification of BRAF mutation prompted the development of new class of targeted therapy for treating melanoma: BRAF inhibitors and MEK inhibitors. Cardiovascular events have been reported with these treatments and could counterbalance their long-term maintenance. RECENT FINDINGS: LVEF decrease due to BRAF and MEK inhibitors appears fairly common (10%) but usually not severe, without impact on patient outcomes. To date, no treatment options have been tested to prevent or to treat a decrease of LVEF associated with BRAF and MEK inhibitors. QTc prolongation was observed in 3% and arterial hypertension in 20% during treatment but only one-third of cases required a therapeutic change. BRAF and MEK inhibitors have revolutionized the management and the prognosis of melanoma patients. Cardio-oncology units may be useful for a better care of potential cardiac toxicity and particularly to inappropriately avoid discontinuing BRAF and MEK inhibitors.
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Authors: Paolo A Ascierto; Grant A McArthur; Brigitte Dréno; Victoria Atkinson; Gabrielle Liszkay; Anna Maria Di Giacomo; Mario Mandalà; Lev Demidov; Daniil Stroyakovskiy; Luc Thomas; Luis de la Cruz-Merino; Caroline Dutriaux; Claus Garbe; Yibing Yan; Matthew Wongchenko; Ilsung Chang; Jessie J Hsu; Daniel O Koralek; Isabelle Rooney; Antoni Ribas; James Larkin Journal: Lancet Oncol Date: 2016-07-30 Impact factor: 41.316
Authors: Nicole H Purcell; Benjamin J Wilkins; Allen York; Marc K Saba-El-Leil; Sylvain Meloche; Jeffrey Robbins; Jeffery D Molkentin Journal: Proc Natl Acad Sci U S A Date: 2007-08-20 Impact factor: 11.205