Abstract：
UNASSIGNED: The introduction of BRAF/MEK inhibitors has significantly improved overall survival of patients with BRAF V600-mutant advanced or metastatic melanoma. Most patients treated with BRAF/MEK inhibitors will experience adverse events during the course of their treatment. Kidney impairment, however, was rarely reported in the pivotal trials. To date, there are only three cases of biopsy-proven acute interstitial nephritis associated with dabrafenib and trametinib reported in the literature.
UNASSIGNED: A 50-year-old man diagnosed with metastatic melanoma was hospitalized in August 2021, 5 months after treatment initiation with dabrafenib and trametinib. He presented with acute kidney injury, with serum creatinine of 3.34 mg/dL and eGFR of 20.3 mL/min/m². Kidney biopsy revealed acute interstitial nephritis.
UNASSIGNED: He was treated with methylprednisolone 16 mg qd, and both dabrafenib and trametinib were permanently discontinued, with recuperation of his kidney function. Another BRAF/MEK inhibitor combination, encorafenib and binimetinib, was introduced, with preserved kidney function and excellent disease control.
UNASSIGNED: We report the first case of biopsy-proven interstitial nephritis in a patient treated with dabrafenib and trametinib, with successful introduction of another BRAF/MEK inhibitor combination. Although rare, clinicians should be aware of the risk of renal adverse events associated with BRAF/MEK inhibitors. Renal biopsy is mandatory in the absence of a clear explanation or rapid recovery of renal failure. In case of proven interstitial nephritis, corticosteroids should be initiated. Switching to another BRAF/MEK inhibitor combination can be considered for patients with complete recovery of renal function and limited treatment options.
UNASSIGNED: A 50-year-old man diagnosed with metastatic melanoma was hospitalized in August 2021, 5 months after treatment initiation with dabrafenib and trametinib. He presented with acute kidney injury, with serum creatinine of 3.34 mg/dL and eGFR of 20.3 mL/min/m². Kidney biopsy revealed acute interstitial nephritis.
UNASSIGNED: He was treated with methylprednisolone 16 mg qd, and both dabrafenib and trametinib were permanently discontinued, with recuperation of his kidney function. Another BRAF/MEK inhibitor combination, encorafenib and binimetinib, was introduced, with preserved kidney function and excellent disease control.
UNASSIGNED: We report the first case of biopsy-proven interstitial nephritis in a patient treated with dabrafenib and trametinib, with successful introduction of another BRAF/MEK inhibitor combination. Although rare, clinicians should be aware of the risk of renal adverse events associated with BRAF/MEK inhibitors. Renal biopsy is mandatory in the absence of a clear explanation or rapid recovery of renal failure. In case of proven interstitial nephritis, corticosteroids should be initiated. Switching to another BRAF/MEK inhibitor combination can be considered for patients with complete recovery of renal function and limited treatment options.
摘要：
■BRAF/MEK抑制剂的引入显着改善了BRAFV600突变的晚期或转移性黑色素瘤患者的总体生存率。大多数用BRAF/MEK抑制剂治疗的患者在治疗过程中会出现不良事件。肾功能损害，然而,在关键试验中很少报道。迄今为止,文献中报道的只有3例经活检证实的急性间质性肾炎与dabrafenib和trametinib相关.
■一名被诊断患有转移性黑色素瘤的50岁男子于2021年8月住院，这是在dabrafenib和trametinib治疗开始5个月后。他出现了急性肾损伤,血清肌酐为3.34mg/dL，eGFR为20.3mL/min/m²。肾活检提示急性间质性肾炎。
■患者接受甲基强的松龙16mgqd治疗，达布拉非尼和曲美替尼都被永久停用，恢复他的肾功能.另一种BRAF/MEK抑制剂组合，恩科非尼和比尼美替尼，被介绍,具有保留的肾功能和出色的疾病控制。
我们报告了首例经活检证实的间质性肾炎患者接受达拉非尼和曲美替尼治疗，成功引入另一种BRAF/MEK抑制剂组合。虽然罕见，临床医师应了解与BRAF/MEK抑制剂相关的肾脏不良事件的风险.在没有明确解释或肾衰竭快速恢复的情况下，必须进行肾活检。在证实的间质性肾炎的情况下，应该开始使用皮质类固醇。对于肾功能完全恢复且治疗选择有限的患者，可以考虑改用另一种BRAF/MEK抑制剂组合。
■一名被诊断患有转移性黑色素瘤的50岁男子于2021年8月住院，这是在dabrafenib和trametinib治疗开始5个月后。他出现了急性肾损伤,血清肌酐为3.34mg/dL，eGFR为20.3mL/min/m²。肾活检提示急性间质性肾炎。
■患者接受甲基强的松龙16mgqd治疗，达布拉非尼和曲美替尼都被永久停用，恢复他的肾功能.另一种BRAF/MEK抑制剂组合，恩科非尼和比尼美替尼，被介绍,具有保留的肾功能和出色的疾病控制。
我们报告了首例经活检证实的间质性肾炎患者接受达拉非尼和曲美替尼治疗，成功引入另一种BRAF/MEK抑制剂组合。虽然罕见，临床医师应了解与BRAF/MEK抑制剂相关的肾脏不良事件的风险.在没有明确解释或肾衰竭快速恢复的情况下，必须进行肾活检。在证实的间质性肾炎的情况下，应该开始使用皮质类固醇。对于肾功能完全恢复且治疗选择有限的患者，可以考虑改用另一种BRAF/MEK抑制剂组合。
