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Nausea and vomiting following off-label treatment: case report A 62-year-old woman developed nausea and vomiting following off-label treatment with dabrafenib for lung adenocarcinoma. Additionally, she received off-label treatment with trametinib [routes, duration of treatment to reaction onset not stated]. The woman, who had hoarseness, cough and chest pain, presented to the clinic. She was ex-smoker. Further clinic investigation revealed lung adenocarcinoma with brain and liver metastases. A subsequent molecular test showed a BRAF G469A mutation and two TP53 mutations. Thereafter, she started receiving first-line chemotherapy with carboplatin and pemetrexed with a response that lasted 5 months. After disease progression, she started receiving second-line therapy with pembrolizumab. However, after several weeks, due to disease progression and pneumonitis, her treatment with pembrolizumab was discontinued. Subsequently, she started receiving third-line therapy with docetaxel without any response to treatment. After 10 months from the disease diagnosis, she started receiving off-label combination therapy with dabrafenib 150mg twice a day and trametinib 2 mg/day. Subsequently, she developed nausea and vomiting secondary to dabrafenib. The woman’s dabrafenib dose was reduced to 75 mg twice a day. Following the dose reduction, her nausea and vomiting resolved. Additionally, her pretreatment fatigue and dyspnea had markedly improved after 1 month from dabrafenib and trametinib therapy. After 2 months, restaging scan showed a reduction in the size of liver masses and stability of the solitary brain lesion. She responded to dabrafenib and trametinib therapies for 6 months. Dagogo-Jack I. Durable Response to Dabrafenib Combined With Trametinib in a Patient With NSCLC Harboring a BRAF G469A Mutation. Journal of Thoracic Oncology 803514584 15: e174-e176, No. 10, Oct 2020. Available from: URL: http://doi.org/10.1016/j.jtho.2020.07.007

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Reactions 14 Nov 2020 No. 1830