Key result
Treatment with BRAF and/or MEK inhibitors in metastatic melanoma patients resulted in a 13.6% incidence of left ventricular ejection fraction decrease, which was generally manageable and did not impact overall survival.
Why the study?
Left ventricular ejection fraction decrease related to BRAF and/or MEK inhibitors in melanoma patients had not been thoroughly evaluated.
Observational (n=88)
No
LVEF decrease is a common but manageable adverse event of BRAF and MEK inhibitors in metastatic melanoma patients, and recovery may be improved with the introduction of ACE inhibitors and beta-blockers.
LVEF-D occurred in 13.6% of BRAF/MEKi-treated melanoma patients; leaves open optimal monitoring strategies in prospective studies.
-mutated melanoma patients. Left ventricular ejection fraction decrease (LVEF-D) related to these treatments has not been thoroughly evaluated to date. The main objective of this study was to describe characteristics of LVEF-D in melanoma patients treated with BRAF and/or MEKis. Metastatic melanoma patients treated with BRAF and/or MEKis between March 1, 2012 and May 18, 2018 were included retrospectively (Lyon Sud University Hospital, Hospices Civils de Lyon). LVEF-D was defined as a reduction in LVEF ≥10% from baseline to a value <55%; normalization was defined as a value ≥55%. Among the 88 patients included, 12 (13.6%) experienced a LVEF-D, including 10 grade 2 and 2 grade 3. The median onset of which was 11 months (IQR [3-21]). No patient previously treated with beta-blockers (n = 12) experienced a LVEF-D. Analysis of laboratory parameters, electrocardiogram, and transthoracic echocardiography during the follow-up did not find any predictive marker of LVEF-D. All patients who benefited from a specific treatment of LVEF-D had a normalization of LVEF at the end of follow-up. LVEF recovery was significantly better for patients treated with angiotensin converting enzyme inhibitors and beta-blockers than those who did not (P = .019). Ophthalmological adverse events were significantly more frequent in patients who experienced a LVEF-D (P = .006) and the latter did not influence overall-survival (P = .117) or progression-free-survival (P = .297). LVEF-D is a common and easily manageable adverse event due to BRAF and MEKis. Its association with ocular toxicity suggests a close ophthalmological monitoring when LVEF-D occurs.
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Berger et al. (2020) conducted an observational in Metastatic melanoma (n=88). BRAF and/or MEK inhibitors was evaluated on Left ventricular ejection fraction decrease (LVEF-D) ≥10% from baseline to <55%. Treatment with BRAF and/or MEK inhibitors in metastatic melanoma patients resulted in a 13.6% incidence of left ventricular ejection fraction decrease, which was generally manageable and did not impact overall survival.
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