Kaitlyn D’Onofrio

DocwireNews

<a href="https://www.docwirenews.com/abstracts/association-between-surgical-skin-markings-in-dermoscopic-images-and-diagnostic-performance-of-a-deep-learning-convolutional-neural-network-for-melanoma-recognition/">Melanoma</a> patients who undergo treatment with BRAF and MEK inhibitors may be more likely to sustain cardiovascular adverse events (CVAEs) compared to patients receiving BRAF inhibitor monotherapy, according to a recent systematic review and meta-analysis.&ldquo;The nature and incidence of CVAEs associated with BRAF and MEK inhibitor therapy are incompletely described. However, cardiovascular complications may affect a patient&rsquo;s quality of life or may require temporary or permanent cancer therapy termination,&rdquo; wrote the study authors, whose work was published in <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2747695">JAMA Network Open</a>.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Combination Therapy for Melanoma May Increase Cardiovascular Risks <a href="https://t.co/xO2KfuiDmC">https://t.co/xO2KfuiDmC</a> via <a href="https://twitter.com/mydocwire?ref_src=twsrc%5Etfw">@mydocwire</a> <a href="https://twitter.com/hashtag/CardioOnc?src=hash&amp;ref_src=twsrc%5Etfw">#CardioOnc</a> <a href="https://twitter.com/ICOSociety?ref_src=twsrc%5Etfw">@ICOSociety</a> <a href="https://twitter.com/EuroCardioOnc?ref_src=twsrc%5Etfw">@EuroCardioOnc</a> <a href="https://twitter.com/OSUCCC_James?ref_src=twsrc%5Etfw">@OSUCCC_James</a>
&mdash; R.R. Baliga, MD (@OSUCardioOnc) <a href="https://twitter.com/OSUCardioOnc/status/1160979501406289920?ref_src=twsrc%5Etfw">August 12, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>The researchers queried PubMed, Cochrane, and Web of Science databases; TCTMD, Clinical Trial Results, Medscape, and CardioSource Plus websites; and annual meeting abstracts and presentations from major cardiovascular and cancer societies for studies from the inception of the database until Nov. 30, 2018. The following search terms were used: vemurafenib, dabrafenib, encorafenib, trametinib, binimetinib, and cobinimetinib. All studies were published in English. Primary outcomes were pulmonary embolism, decreased left ventricular ejection fraction, arterial hypertension, myocardial infarction, atrial fibrillation, and QTc interval prolongation.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
What is the rate of CVAEs among patients w/ melanoma treated w/ BRAF &amp; MEK inhibitors compared w/ patients treated w/ BRAF inhibitor monotherapy? Find out in this journal scan: <a href="https://t.co/4R37I9zk0Q">https://t.co/4R37I9zk0Q</a> <a href="https://twitter.com/hashtag/cvEP?src=hash&amp;ref_src=twsrc%5Etfw">#cvEP</a>
&mdash; American College of Cardiology (@ACCinTouch) <a href="https://twitter.com/ACCinTouch/status/1162107950435131398?ref_src=twsrc%5Etfw">August 15, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>Final analysis included five randomized clinical trials encompassing 2,317 <a href="https://www.docwirenews.com/abstracts/hem-onc-abstracts/five-year-outcomes-with-dabrafenib-plus-trametinib-in-metastatic-melanoma-2/">melanoma</a> patients. Patients treated with BRAF and MEK inhibitors, compared to BRAF inhibitor monotherapy, had significantly greater risks for <a href="https://www.docwirenews.com/cardiology/diagnose-prenatal-pulmonary-embolism/">pulmonary embolism</a> (relative risk [RR], 4.36; 95% confidence interval [CI], 1.23-15.44; P&thinsp;=&thinsp;0.02), <a href="https://www.docwirenews.com/abstracts/cardiology-abstracts/structural-and-myocardial-dysfunction-in-heart-failure-beyond-ejection-fraction/">left ventricular ejection fraction</a> decrease (RR, 3.72; 95% CI, 1.74-7.94; P&thinsp;&lt;&thinsp;0.001), and <a href="https://www.docwirenews.com/future-of-medicine/fda-improves-new-heart-implant-to-treat-advanced-heart-failure/">arterial hypertension</a> (RR, 1.49; 95% CI, 1.12-1.97; P&thinsp;=&thinsp;0.005). There were no significant between-group differences in risks for <a href="https://www.docwirenews.com/abstracts/cardiology-abstracts/blood-leukocyte-dna-methylation-predicts-risk-of-future-myocardial-infarction-and-coronary-heart-disease/">myocardial infarction</a>, atrial fibrillation, and QTc prolongation. Risks were also increased when evaluating certain high-grade CVAEs, including left ventricular ejection fraction (RR, 2.79; 95% CI, 1.36-5.73; P&thinsp;=&thinsp;0.005; I2&thinsp;=&thinsp;29%) and high-grade arterial hypertension (RR, 1.54; 95% CI, 1.14-2.08; P&thinsp;=&thinsp;0.005; I2&thinsp;=&thinsp;0%), but there were no significant between-group differences in high-grade <a href="https://www.docwirenews.com/docwire-pick/electronic-tool-successfully-determines/">pulmonary embolism</a>. Left ventricular ejection fraction risk was significantly higher in patients with a mean age younger than 55 years (RR, 26.50; 95% CI, 3.58-196.10; P&thinsp;=&thinsp;0.001), while pulmonary embolism was more likely to occur in patients with a mean follow-up time longer than 15 months (RR, 7.70; 95% CI, 1.40-42.12; P&thinsp;=&thinsp;0.02).The authors concluded that &ldquo;therapy with BRAF and MEK inhibitors was associated with an increased risk of CVAEs, especially pulmonary embolism, a decrease in LVEF, and arterial hypertension, compared with BRAF inhibitor monotherapy&rdquo;; they also recommended, &ldquo;These adverse events should be carefully approached in cardio-oncology teams for an optimal treatment of patients with melanoma.&rdquo;

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