Braftovi® (encorafenib) and Mektovi® (binimetinib)

Reviewed by: HU Medical Review Board

Braftovi and Mektovi are a combination targeted therapy to treat melanoma that cannot be surgically removed (unresectable) or metastatic (has spread to other parts of the body) melanoma with a BRAF V600E or V600K mutation. This mutation is detected through a test of the cancerous cells. When this mutation is present, it can stimulate cancerous growth.1,2

How does the combination of Braftovi and Mektovi work?

Braftovi and Mektovi block two different proteins in a particular pathway that is involved in cancer cell growth. Approximately one-third of melanomas have mutations in the gene (instructions) for a protein called BRAF.3 This mutation can cause cancer cells to grow out of control. The MEK protein is also involved in how cells grow and divide, and it is signaled by the BRAF protein. By targeting these proteins in combination, Braftovi and Mektovi can help shrink melanoma tumors and help patients live longer without their disease getting worse.1,2,4

What are the possible side effects of Braftovi and Mektovi?

In some people, Braftovi may cause serious side effects, including:1,5

  • An increased risk of new skin cancers (cutaneous squamous cell carcinoma or basal cell carcinoma)
  • Bleeding problems, such as bleeding in the stomach or brain which may be fatal
  • Eye problems, leading to blurred vision, loss of vision, or other changes in vision
  • Changes in heart rhythm, called QT prolongation

Mektovi can also cause serious side effects, including:2,5

  • Heart problems or heart failure
  • Blood clots, which can cause chest pain, trouble breathing, swelling in the arms or legs, and may lead to death
  • Eye problems which may lead to blindness
  • Lung or breathing problems
  • Liver problems, which may cause jaundice (yellowing of the whites of the eyes or skin)
  • Muscle problems (rhabdomyolysis), which may be severe
  • Bleeding problems, such as bleeding in the stomach or brain which may be fatal

The most common side effects of Braftovi and Mektovi combination therapy include:5

  • Fatigue
  • Nausea and vomiting
  • Abdominal pain
  • Joint pain or swelling
  • Diarrhea

This is not an exhaustive list of all potential side effects of Braftovi and Mektovi. Talk to your healthcare provider or pharmacist for further information.

Things to know about Braftovi and Mektovi

Before starting treatment with Braftovi and Mektovi, patients should talk to their doctor about all their health conditions, including:1,2,5

  • Bleeding problems
  • Eye problems
  • Heart problems
  • Low levels of potassium, calcium, or magnesium
  • Liver or kidney problems
  • History of blood clots
  • Lung or breathing problems
  • Muscle problems
  • High blood pressure (hypertension)

If you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed, talk with your doctor. Braftovi and Mektovi can cause harm to a developing fetus and should not be taken by women who are pregnant.1,2,5 While taking Braftovi and Mektovi, females who can become pregnant should use contraceptives during treatment and for a period of time after completing treatment (patients should discuss appropriate birth control methods, and how long they need to use them, with their doctor). Females should not breastfeed during Braftovi and Mektovi treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).

Because Braftovi may increase the risk of developing new skin cancers, people taking Braftovi should receive regular skin examinations by a dermatologist or other healthcare professional before, during, and after treatment.1,2,5

Braftovi should not be used by people with a wild-type BRAF melanoma, as it may cause these types of cancers to grow more. The BRAF mutation should be determined prior to starting treatment with a FDA-approved test.1,5

Grapefruit products should be avoided while taking Braftovi, as they may increase the amount of the medication in the body and cause more side effects.1,5

Receiving Braftovi and Mektovi

Braftovi and Mektovi should be taken by mouth. Patients should not stop taking Braftovi and Mektovi without talking to their doctor. Patients should also talk to their doctor if they have questions about how to take Braftovi and Mektovi.5 You should take your medication as prescribed by your doctor. Before starting treatment with Braftovi and Mektovi, patients should tell their doctor about all medications (prescription and over-the-counter), herbal supplements, and vitamins they are taking.

For more information, read the full prescribing information of Braftovi and the full prescribing information of Mektovi.

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