Brooke Looney, PharmD, certified specialty pharmacist in the Oncology Clinic at Vanderbilt Specialty Pharmacy, discusses medication changes and adverse events for patients starting encorafenib and binimetinib.
In an interview with Pharmacy Times® at the American Society of Health-System Pharmacists Summer Meetings and Exhibition, Brooke Looney, PharmD, certified specialty pharmacist in the Oncology Clinic at Vanderbilt Specialty Pharmacy, discusses medication changes and adverse events for patients starting encorafenib and binimetinib.
Q: What are the considerations for initiating treatment with encorafenib and binimetinib combination therapy?
Brooke Looney: Patients with unresectable or metastatic melanoma with a BRAF V600K or E mutation are patients that should be considered for therapy. Patients that do not harbor the BRAF mutation, so patients that are BRAF wild type should not be considered for therapy.
Q: What should pharmacists know about medication changes for patients initiating this treatment?
Brooke Looney: Pharmacists should be aware of any medication changes for patients initiating treatment because there is a drug-drug interaction with the CYP3A4 substrates, inducers, and inhibitors.
Q: What adverse events should pharmacists be aware of?
Brooke Looney: Some common side effects that are seen in patients are rash, nausea, vomiting, diarrhea, and arthralgias. Patients also can experience fevers, elevated liver enzymes, decreased appetite, and myalgias.
Q: How should a pharmacist assist a patient who is experiencing these adverse events?
Brooke Looney: Pharmacists should counsel patients on mitigating strategies for these adverse events, such as anti-diarrheal, antipyretics, and anti-emetics. Pharmacists should also counsel patients on when to notify their providers. If these side effects are not being controlled by the mitigating strategies you discussed, the patients should reach out to the provider.
Q: How can pharmacists help to improve outcomes among patients on this treatment regimen?
Brooke Looney: Pharmacists can help improve patient outcomes by ensuring that patients are educated in advance on the side effects that they should be expecting and looking out for. Also, pharmacists can ensure that patients have the mitigating agents that we have discussed previously on hand, so that they have an anti-medic on hand or anti-diarrheal tablets in case needed. In addition, pharmacist can reach out to the patients especially in that first few weeks to months after initiating therapy when we do tend to see these common side effects present to check in on the patient. ensure they are maximizing the anti-diarrheal or anti-emetics and also just to answer any questions that patients might have and provide support in mitigating those side effects.