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Cotellic (cobimetinib)

Reviewed by: HU Medical Review Board | Last reviewed: February, 2022.

Cotellic® (cobimetinib) is used to treat certain kinds of advanced melanoma. Cotellic is taken in combination with a drug called Zelboraf® (vemurafenib).1 Cotellic treats melanoma with BRAF V600E or V600K mutation. Your doctor will test for BRAF mutation. Cotellic is not used for melanoma with a normal BRAF gene.

Cotellic is used when the melanoma:1

  • Cannot be removed with surgery (unresectable) or
  • Has spread to distant parts of the body (metastasized)

The combination of Cotellic and vemurafenib targeted therapies may also be used together with Tecentriq® (atezolizumab) immunotherapy for metastatic or unresectable melanoma that has the BRAF V600 mutation.

Cotellic does not come in generic form. Cotellic is similar to Mekinist® (trametinib), another drug approved to treat certain forms of melanoma.

How does Cotellic work?

Cotellic is a type of medication called a kinase inhibitor. It works by blocking a protein called MEK that passes along signals for cell growth.

MEK is a protein in a pathway called MAPK (also called ERK). This pathway involves a chain of events that allow cells to grow and survive. Normally, there are mechanisms that turn each protein “on” and “off.” These mechanisms keep cell processes under control. However, approximately one-third of melanomas have mutations in the gene (instructions) for a protein called BRAF.2 These mutations cause BRAF to stay “on,” sending continuous signals resulting in uncontrolled cell growth.3

MEK comes after BRAF in this chain of events. Cotellic blocks MEK from working and stops the signal from continuing. Cotellic is called a targeted therapy because it targets one feature that makes cancer cells different from normal cells.

Zelboraf is a BRAF inhibitor. When Zelboraf and Cotellic are used together, they target the MAPK pathway at two points. This combination stops or slows the growth of melanomas with BRAF mutations better for some people than either drug alone (cobimetinib is only approved to be used in combination with vemurafenib for treating melanoma).1

Receiving Cotellic

Before taking Cotellic, read the Medication Guide that comes in the package. Follow your doctor’s instructions for taking Cotellic.

Cotellic comes as tablets that are taken by mouth.1 Patients should take their medication as prescribed by their doctor. Patients should talk to their doctor if they have any questions, or if they have questions regarding their cobimetinib regimen.

Based on your doctor’s instructions, you will continue cycles of Cotellic until the cancer progresses or the side effects are unacceptable.1

What are the side effects of Cotellic?

You are at risk of new cancers while taking Cotellic.1 This medication has been linked to other types of skin cancer such as cutaneous squamous cell carcinoma, keratoacanthoma, and basal cell carcinoma. Possible signs of new cancers include: new wart, skin sore, reddish bump, or mole that changes in size or color (patients should tell their doctor if they notice any of these skin changes).

The most common side effects of Cotellic include:1

  • Nausea and vomiting
  • Fever
  • Diarrhea
  • Sun sensitivity (photosensitivity)

Less common but serious side effects of Cotellic include:1

  • Bleeding problems
  • Heart problems
  • Severe skin reaction
  • Eye problems
  • Liver problems
  • Muscle problems (also called rhabdomyolysis)

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

Who should not take Cotellic?

If you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed, talk with your doctor. Cotellic can cause harm to a developing fetus and should not be taken by women who are pregnant.1 While taking Cotellic, 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 Cotellic treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).

Tell your doctor about any medical conditions you have, especially:

  • Current or past skin problems
  • Bleeding problems
  • Heart problems
  • Eye problems
  • Liver problems
  • Muscle problems

What precautions are needed when taking Cotellic?

You will need regular skin exams while taking Cotellic.1 Your doctor will do a skin exam before you start this medication. You will need skin exams every 2 months while taking this medication and for up to 6 months afterward. Your doctor will also look for non-skin cancers.

Try to avoid sunlight while taking Cotellic.1 This medication may make your skin sensitive to sunlight and you may burn more easily. If you are outside, wear a wide-brimmed hat and long clothing. Use sunscreen and lip balm with a sun protection factor (SPF) of 30 or more.

Before starting treatment with Cobimetinib, patients should tell their doctor about all medications (prescription and over-the-counter), herbal supplements, and vitamins they are taking.

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