Melanoma — SCE Dermatology MCQ

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ModerateSkin CancerMelanomaSCE Dermatology

A 75-year-old man with advanced melanoma (BRAF V600E mutant) has been started on combination targeted therapy with Dabrafenib and Trametinib. What are the respective targets of these drugs?

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Correct answer: E — BRAF and MEK inhibitor

Dabrafenib is a BRAF inhibitor and Trametinib is a MEK inhibitor. Together they provide dual blockade of the MAPK/ERK signalling pathway in BRAF V600-mutant melanoma. Combination therapy reduces the paradoxical MAPK pathway reactivation seen with single-agent BRAF inhibitors and decreases the incidence of cutaneous SCC (a side effect of BRAF monotherapy). Side effects include pyrexia, fatigue, and less commonly cardiomyopathy. NICE recommends combination BRAF/MEK inhibition for unresectable/metastatic BRAF V600-mutant melanoma and as adjuvant therapy for resected stage III disease.

Reference: NICE TA396 2016; BAD 2017 Melanoma Guidelines