Abstract：
BACKGROUND: Dabrafenib and trametinib are oral targeted agents indicated for BRAF mutated non-small cell lung cancer and melanoma. There is little data to support the administration of these two agents via enteral feeding tube. This case series describes three patients who received compounded dabrafenib and trametinib suspensions through enteral feeding tubes.
METHODS: We present three patients who required dabrafenib and trametinib to be prepared as a non-standard compound for the medications to be administered via feeding tube. The patients were diagnosed with with BRAF mutated cancers including melanoma, non-small-cell lung carcinoma, and anaplastic thyroid cancer. In all three cases, there was evidence of initial disease response on imaging, and there were no unexpected toxicities secondary to dabrafenib and trametinib.
CONCLUSIONS: There are patients that are unable to tolerate medications by mouth due to dysphagia, anatomical malfunctions, or other digestive disorders. There is limited literature that describes preparation of trametinib and dabrafenib into an enteral suspension. Identifying a safe and efficacious method of administering these two medications via feeding tube ensures that these patients continue to be able to receive them as part of their anti-cancer therapy.
CONCLUSIONS: Despite the lack of available data, compounding of dabrafenib and trametinib may be clinically appropriate when benefits outweigh the risk of unconventional administration. Further studies are warranted to assess for the pharmacokinetics, pharmacodynamics, stability, and storage for these liquid medications.
METHODS: We present three patients who required dabrafenib and trametinib to be prepared as a non-standard compound for the medications to be administered via feeding tube. The patients were diagnosed with with BRAF mutated cancers including melanoma, non-small-cell lung carcinoma, and anaplastic thyroid cancer. In all three cases, there was evidence of initial disease response on imaging, and there were no unexpected toxicities secondary to dabrafenib and trametinib.
CONCLUSIONS: There are patients that are unable to tolerate medications by mouth due to dysphagia, anatomical malfunctions, or other digestive disorders. There is limited literature that describes preparation of trametinib and dabrafenib into an enteral suspension. Identifying a safe and efficacious method of administering these two medications via feeding tube ensures that these patients continue to be able to receive them as part of their anti-cancer therapy.
CONCLUSIONS: Despite the lack of available data, compounding of dabrafenib and trametinib may be clinically appropriate when benefits outweigh the risk of unconventional administration. Further studies are warranted to assess for the pharmacokinetics, pharmacodynamics, stability, and storage for these liquid medications.
摘要：
背景：Dabrafenib和trametinib是口服靶向药物，适用于BRAF突变的非小细胞肺癌和黑色素瘤。很少有数据支持通过肠内饲管施用这两种药剂。该病例系列描述了三名通过肠内饲管接受复合达拉非尼和曲美替尼悬浮液的患者。病例报告：我们介绍了三名患者，他们需要将dabrafenib和trametinib制备为非标准化合物，用于通过饲管给药。这些患者被诊断出患有BRAF突变的癌症，包括黑色素瘤，非小细胞肺癌,和间变性甲状腺癌。在这三种情况下，影像学上有初步疾病反应的证据，并且没有达拉非尼和曲美替尼继发的意外毒性。讨论：有些患者由于吞咽困难而无法口服药物，解剖学故障,或其他消化系统疾病。有限的文献描述了将曲美替尼和达拉非尼制备为肠混悬液。确定通过饲管施用这两种药物的安全和有效的方法确保这些患者能够继续接受它们作为其抗癌治疗的一部分。结论：尽管缺乏可用的数据，当益处大于非常规给药的风险时,dabrafenib和trametinib的复合可能在临床上是合适的.需要进一步的研究来评估药代动力学，药效学,稳定性,和储存这些液体药物。
