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Real-World Cardiotoxicity in Metastatic Melanoma Patients Treated with Encorafenib and Binimetinib
by
, , ,
Sidsel Pedersen
1,*,
Marc Østergaard Nielsen
2,
Marco Donia
1
,
Inge Marie Svane
1
,
Bo Zerahn
2 and
Eva Ellebaek
1 1
Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark
2
Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Herlev and Gentofte, 2730 Herlev, Denmark
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(17), 2945; https://doi.org/10.3390/cancers16172945
Submission received: 24 July 2024
/
Revised: 16 August 2024
/
Accepted: 23 August 2024
/
Published: 23 August 2024
(This article belongs to the Special Issue Melanoma: Clinical Trials and Translational Research)
Simple Summary
Targeted therapies with BRAF- and MEK-inhibitors have significantly improved outcomes for patients with metastatic melanoma, but they come with a risk of heart-related side effects. This study included 108 real-world patients with metastatic melanoma from Eastern Denmark from 2019–2022 treated with encorafenib and binimetinib. Heart function was monitored with MUGA scans at baseline and every three months. While 18% of the patients experienced minor heart issues without symptoms, only 6% faced major problems, some needing medical intervention. However, no severe heart issues occurred beyond six months of starting the treatment. This suggests that it might be safe to reduce heart monitoring after six to nine months if no issues appear early on.
Abstract
Modern therapies targeting the BRAF gene mutation in advanced melanoma have significantly improved patient outcomes but pose cardiovascular risks. This retrospective study in Eastern Denmark (2019–2022) assessed 108 melanoma patients treated with encorafenib and binimetinib. Patients were monitored for heart function using multigated acquisition (MUGA) scans. The study defined major cardiotoxicity as a decline in left ventricular ejection fraction (LVEF) by more than 10 percentage points to below 50%, and minor cardiotoxicity as a decrease in LVEF by more than 15 points but remaining above 50%. Results showed that 19 patients (18%) developed minor cardiotoxicity and were asymptomatic, while 7 (6%) experienced major cardiotoxicity, with two requiring intervention. Notably, no significant declines in LVEF were observed after six months of treatment. The study concluded that significant cardiotoxicity occurred in 6% of cases, mostly asymptomatic and reversible, and suggests that monitoring LVEF could potentially be reduced after 6–9 months if no early signs of cardiotoxicity are detected. This provides valuable insights into the cardiac safety of these treatments in real-world settings.
