Medical Information

Encorafenib, as a BRAF inhibitor, commonly has side effects such as skin reactions, bleeding tendency, and cardiac toxicity. Dosage adjustments or symptomatic treatment should be taken according to the severity of the condition. At the same time, attention should be paid to serious adverse reactions such as QT interval prolongation and new malignant tumors.

Serious side effects that require immediate medical attention

(1) Cardiovascular symptoms: rapid/irregular heartbeat, chest pain, difficulty breathing with dizziness, suggesting possible QT interval prolongation or heart failure.

(2) Bleeding manifestations: black stool, coughing up blood, abnormal bruising or needle like bleeding points, reflecting the risk of thrombocytopenia.

(3) Eye problems: Changes in vision, halo or eye pain, which may be caused by uveitis or retinal detachment.

2 common side effects mitigation measures

(1) Skin reaction: Hand foot syndrome requires keeping the skin moist and avoiding friction; Severe rash requires temporary suspension of medication and local use of corticosteroids.

(2) Gastrointestinal symptoms: Nausea and vomiting can be treated by adjusting the medication time and combining antiemetic drugs; Supplement electrolytes during diarrhea.

(3) Fatigue and pain: staged activity plan, use nonsteroidal anti-inflammatory drugs if necessary (excluding bleeding risk).

3 Special Risk Prevention

(1) Infection prevention: Regularly monitor blood routine, avoid contact with infectious sources, and seek medical attention immediately if fever occurs.

(2) Skin cancer screening: Skin examinations should be conducted every 2-3 months during treatment, and strict sun protection (SPF ≥ 30) should be implemented.

(3) Drug interactions: Avoid using CYP3A4 potent inhibitors/inducers in combination, and adjust the dosage when necessary.

4 Principles of Dose Adjustment

(1) First reduction: from 450mg/day to 300mg (melanoma) or 225mg (colorectal cancer).

(2) Abnormal liver function: AST/ALT grade 3 medication needs to be temporarily suspended, and the dosage should be reduced and restarted after recovery; Consider permanent discontinuation of medication at level 4.

(3) QT interval prolongation: If QTcF>500ms, permanent discontinuation is required. If QTcF>500ms but the increase is ≤ 60ms, the dosage can be reduced and continued.

5 Precautions for Special Groups

(1) Pregnant women: There is a risk of fetal malformation, and reliable contraceptive measures should be taken during medication.

(2) Liver damage patients: There is no clear recommended dosage for moderate to severe liver dysfunction (Child Pugh B/C).

(3) Elderly patients: No need for routine dose adjustment, but need to strengthen cardiovascular monitoring.