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Patient Handout: Dabrafenib and Trametinib (Tafinlar + Mekinist)

What are Dabrafenib and Trametinib?

Dabrafenib (brand name Tafinlar) and trametinib (brand name Mekinist) are two medications used together to treat advanced solid tumors with BRAF gene mutations. Both drugs are targeted therapies that help slow down or stop the growth of cancer cells.

  • Dabrafenib is a BRAF inhibitor that works by blocking a mutated BRAF protein. This protein is often found in cancers such as melanoma, non-small cell lung cancer (NSCLC), and thyroid cancer. By blocking BRAF, dabrafenib helps prevent cancer cells from growing and dividing.
  • Trametinib is a MEK inhibitor that blocks the MEK protein, which is part of the same signaling pathway that the BRAF protein activates to promote cancer cell growth. By inhibiting MEK, trametinib further helps prevent cancer cell growth and survival.

When used together, dabrafenib and trametinib target both parts of the BRAF/MEK pathway to more effectively control cancer growth.

How Do Dabrafenib and Trametinib Work Together?

Cancer cells can grow uncontrollably when specific genes or proteins become mutated. In some cancers, a mutation in the BRAF gene leads to overactive cell growth. Dabrafenib targets this mutated BRAF protein, while trametinib blocks MEK, another protein in the same pathway that promotes cancer cell growth.

Using both medications together helps to block the cancer from growing and spreading by targeting different points in the signaling pathway that controls cell division and survival.

How are Dabrafenib and Trametinib Taken?

Both dabrafenib and trametinib are taken by mouth in the form of pills.

  • Dabrafenib (Tafinlar): Usually taken twice a day with or without food.
  • Trametinib (Mekinist): Usually taken once a day on a continuous basis.

The exact dosage will be determined by your healthcare provider based on the type of cancer you are being treated for, your response to treatment, and any other health factors.

Important Administration Information:

  • Take both medications exactly as prescribed by your doctor.
  • Do not take more or less than the prescribed dose.
  • Try to take the medications at the same time each day to help remember.
  • If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose. Do not take two doses at once.

Possible Side Effects

Dabrafenib and trametinib can cause side effects, some of which may be serious. It’s important to discuss any concerns with your doctor.

Common Side Effects:

  • Fever: A mild fever can be common. If it is severe or persistent, contact your doctor.
  • Fatigue: Tiredness or weakness can occur during treatment. It’s important to rest when needed.
  • Rash: Skin rashes, including acne-like rash, can develop. In some cases, the rash may become severe.
  • Nausea and Vomiting: Some patients experience nausea, which may lead to vomiting. Anti-nausea medications can help.
  • Headache: A headache may occur, and over-the-counter pain relievers can be used if recommended by your healthcare provider.
  • Joint pain and muscle pain: These can be common but should be reported to your doctor if they become severe.

Serious Side Effects:

  • Skin Cancer (non-melanoma): Dabrafenib and trametinib can increase the risk of other skin cancers, particularly basal cell carcinoma or squamous cell carcinoma. Your doctor will monitor your skin regularly for changes.
  • Eye Problems: Vision changes, such as blurry vision, can occur with trametinib. Contact your doctor if you notice any visual changes.
  • Heart Problems: Trametinib may cause heart problems, including a decrease in heart function. Symptoms like shortness of breath or swelling in the legs should be reported.
  • Lung Issues: Both drugs can sometimes cause lung problems. Signs include shortness of breath, cough, or chest pain.
  • Severe Rash: Rash that becomes severe or blistering, especially with fever, should be reported immediately.
  • Bleeding Problems: Trametinib can sometimes cause bleeding or clotting problems. Report any unusual bruising, bleeding, or nosebleeds to your doctor.
  • Severe Diarrhea: Both medications can cause diarrhea, which should be managed promptly to avoid dehydration.

Precautions Before Taking Dabrafenib and Trametinib

Before starting treatment with dabrafenib and trametinib, it is important to inform your healthcare provider if you:

  • Have any heart problems, including a history of heart disease or irregular heartbeat.
  • Have liver problems: Both drugs are processed in the liver, so your doctor will need to monitor your liver function.
  • Have eye problems, as trametinib can cause visual disturbances.
  • Are pregnant or planning to become pregnant: Dabrafenib and trametinib can harm an unborn baby. You should use effective birth control during treatment and for at least 2 weeks after your last dose of dabrafenib and 4 months after your last dose of trametinib.
  • Are breastfeeding: Both medications may pass into breast milk, so breastfeeding is not recommended while using these drugs.

What to Avoid While Taking Dabrafenib and Trametinib

  • Pregnancy: As mentioned, both medications can harm an unborn baby, so avoid becoming pregnant during treatment. Use contraception during treatment and for a period after stopping the medications.
  • Sun Exposure: Dabrafenib can make your skin more sensitive to the sun. Avoid excessive sun exposure, and use sunscreen and protective clothing when outdoors.
  • Live Vaccines: You should not receive live vaccines during treatment, as your immune system may be weakened by these drugs.
  • Grapefruit: Avoid consuming grapefruit or grapefruit juice while on these medications, as it can interfere with how the drugs are processed in your body.

Regular Monitoring

Your healthcare provider will need to monitor your health throughout treatment with regular tests and exams, including:

  • Blood tests: To check liver function, kidney function, and blood counts.
  • Skin exams: Your doctor will regularly check for any signs of new skin cancer or changes in existing skin lesions.
  • Heart function: Your doctor may check your heart’s function, especially if you have preexisting heart conditions.
  • Eye exams: Vision should be monitored during treatment, as trametinib can cause eye problems.

When to Contact Your Doctor

Call your healthcare provider immediately if you experience any of the following:

  • Severe rash or blistering skin
  • Shortness of breath, chest pain, or difficulty breathing
  • Unusual bruising or bleeding, such as nosebleeds or red spots on your skin
  • Signs of eye problems, such as blurry vision or eye pain
  • Severe diarrhea, blood in your stool, or dehydration
  • Fever over 100.4°F (38°C) or persistent fever

Disclaimer:

This handout is for educational purposes only and should not be considered medical advice. Always follow the instructions provided by your healthcare provider regarding treatment and care. For personalized advice, consult your healthcare provider or pharmacist.