skip to main content

Dabrafenib Pyrexia — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

EasyMelanoma & SkinDabrafenib PyrexiaSCE Medical Oncology

A 62-year-old man with metastatic melanoma on combination dabrafenib + trametinib develops persistent pyrexia (temperature 39°C for 3 days). Infection screen is negative. CRP is mildly elevated. Neutrophils are normal. What is the likely cause and management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Dabrafenib-associated pyrexia — manage with treatment interruption and paracetamol; restart at same or reduced dose once afebrile for 24 hours; if recurrent, consider prophylactic corticosteroids

Pyrexia is the most common adverse effect of dabrafenib (occurring in ~50% of patients, grade 3 in ~5%), and is also seen with combination dabrafenib + trametinib. It typically occurs in the first month, can be recurrent, and is caused by a non-infective inflammatory mechanism. Management: (1) treatment interruption until afebrile ≥24 hours, (2) restart at same dose, (3) if recurrent pyrexia, dose reduce and/or add prophylactic corticosteroids (prednisolone 10-20 mg). Infection must always be excluded.

Reference: BNF Dabrafenib; ESMO 2024 Melanoma; COMBI-v/d safety