Treatment combinations in BRAF-mutant metastatic melanoma.

Combinations of BRAF and MEK inhibitors are now the standard treatment in patients with BRAF V600-mutant metastatic melanoma. Three combination treatments with BRAF and MEK inhibitors are available for thetreatment of metastatic melanoma: vemurafenib + cobimetinib, dabrafenib + trametinib, encorafenib + binimetinib. These 3 combination treatments have distinct safety profiles as evidenced by the data from the phase III studies. For example, fever was observed more frequently in patients treated with dabrafenib and trametinib, photosensitivity in patients treated with vemurafenib and cobimetinib while patients treated with the encorafenib + binimetinib combination have a higher incidence of adverse events related to gastrointestinal system. Considering the similar clinical efficacy demonstrated by the three BRAFi + MEKi combinations, the therapeutic decision is often based on the side effect profile that characterizes each of the combinations.