Clinical Pharmacy Initiatives Contribute to the Excellent Efficacy of the Dabrafenib/Trametinib Combination for Iodine-Refractory Thyroid Carcinoma: A Case Report
Abstract
:1. Introduction
2. Case Presentation
3. Treatment
Time after Treatment Initiation (Months) | Adverse Event Experienced | Grade (CTCAE v5) [30] | Actions Taken |
---|---|---|---|
1 | Weight loss (2 kg) | low | Treatment unchanged |
1.5 | Loss of appetite, weight loss (1 kg), stomach pains, nocturnal excessive sweating | low | Treatment unchanged, dietary and health advice |
2 | Hypokalemia | low | Potassium supplementation (2 pills per day for 7 days) + biological check-up 1 week later |
2.25 | Low blood pressure | low | Decrease in dosage of irbesartan from 300 mg per day to 150 mg per day |
2.5 | Nocturnal excessive sweating, chills | low | Treatment suspension for 1 week |
3 | Liver toxicity | high | Treatment suspension for 1 month and treatment resumption at appropriate dose → First dose reduction |
3.5 | Nocturnal excessive sweating, edema of the right leg, loss of appetite | low | Treatment suspension for 1 week Paracetamol 500 mg in the evening Echo-Doppler Treatment resumption at an appropriate dose → second dose reduction |
4 | Tremors, weight loss, nocturnal excessive sweating | low | Treatment unchanged |
5.5 | TSH increase | low | Increase in levothyroxine dosage from 125 µg to 150 µg per day |
7 | Nocturnal excessive sweating, nausea, tremors, loss of appetite | low | Treatment suspension for 1 week |
8 | TSH increase | low | Increase in levothyroxine dosage from 150 to 175 µg per day |
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Dose Levels | Dosage of Dabrafenib (Twice a Day) | Dosage of Trametinib (Once a Day) |
---|---|---|
Initial dose | 150 mg | 2 mg |
Tier 1 dose reduction | 100 mg | 1.5 mg |
Tier 2 dose reduction | 75 mg | 1 mg |
Tier 3 dose reduction | 50 mg | 1 mg |
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Donzé, C.; Leenhardt, F.; Vinches, M.; Eberlé, M.-C.; Fersing, C. Clinical Pharmacy Initiatives Contribute to the Excellent Efficacy of the Dabrafenib/Trametinib Combination for Iodine-Refractory Thyroid Carcinoma: A Case Report. Medicina 2024, 60, 1037. https://doi.org/10.3390/medicina60071037
Donzé C, Leenhardt F, Vinches M, Eberlé M-C, Fersing C. Clinical Pharmacy Initiatives Contribute to the Excellent Efficacy of the Dabrafenib/Trametinib Combination for Iodine-Refractory Thyroid Carcinoma: A Case Report. Medicina. 2024; 60(7):1037. https://doi.org/10.3390/medicina60071037
Chicago/Turabian StyleDonzé, Charlotte, Fanny Leenhardt, Marie Vinches, Marie-Claude Eberlé, and Cyril Fersing. 2024. "Clinical Pharmacy Initiatives Contribute to the Excellent Efficacy of the Dabrafenib/Trametinib Combination for Iodine-Refractory Thyroid Carcinoma: A Case Report" Medicina 60, no. 7: 1037. https://doi.org/10.3390/medicina60071037