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Blood Rev ; 51: 100888, 2022 01.
Article in English | MEDLINE | ID: covidwho-1385128


Hairy cell leukemia (HCL) is an indolent B-cell malignancy, usually driven by the BRAF V600E mutation. For 30 years, untreated and relapsed HCL was successfully treated with purine analogs, but minimal residual disease (MRD) remained in most patients, eventually causing relapse. Repeated purine analogs achieve decreasing efficacy and increasing toxicity, particularly to normal T-cells. MRD-free complete remissions (CRs) are more common using rituximab with purine analogs in both 1st-line and relapsed settings. BRAF inhibitors and Ibrutinib can achieve remission, but due to persistence of MRD, must be used chronically to prevent relapse. BRAF inhibition combined with Rituximab can achieve high MRD-free CR rates. Anti-CD22 recombinant immunotoxin moxetumomab pasudotox is FDA-approved in the relapsed setting and is unique in achieving high MRD-free CR rates as a single-agent. Avoiding chemotherapy and rituximab may be important in ensuring both recovery from COVID-19 and successful COVID-19 vaccination, an area of continued investigation.

COVID-19 , Leukemia, Hairy Cell/diagnosis , Leukemia, Hairy Cell/therapy , Pandemics , Antineoplastic Agents/therapeutic use , COVID-19/epidemiology , Humans , Leukemia, Hairy Cell/epidemiology , Neoplasm, Residual/diagnosis , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Purines/therapeutic use , Recurrence , Rituximab/therapeutic use
Anticancer Drugs ; 32(5): 589-591, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1082921


Encorafenib (Braftovi) is indicated for the treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation, in combination with binimetinib (Mektovi). According to the product label of encorafenib, there are no specific treatment recommendations in case of an overdose. We report on a 63-year-old man who ingested a double dose (900 mg) of encorafenib for 16 days. He developed overall minor chronic overdose symptoms such as nausea and vomiting grade 1 and muscle pain. Based on the most occurring adverse events of encorafenib, liver values, kidney function parameters and QTc interval were measured. Kidney function parameters were normal, whereas liver values were slightly increased (grade 1) and QTc slightly prolonged. The plasma concentration 3 h after the last dose was 2110 ng/mL. We describe the course of a case with a chronic overdose during 16 days of the double dose of encorafenib as well as the followed approach, which could be taken into account when observing an encorafenib overdose. Providing information in times of Covid-19 is challenging, but remains necessary for good clinical care.

Carbamates , Drug Overdose , Liver Function Tests/methods , Long QT Syndrome , Medication Therapy Management/standards , Melanoma , Skin Neoplasms , Sulfonamides , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Antineoplastic Agents/blood , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Benzimidazoles/administration & dosage , Benzimidazoles/adverse effects , COVID-19/epidemiology , Carbamates/administration & dosage , Carbamates/adverse effects , Carbamates/blood , Communicable Disease Control , Dose-Response Relationship, Drug , Drug Monitoring/methods , Drug Overdose/blood , Drug Overdose/diagnosis , Drug Overdose/etiology , Drug Overdose/physiopathology , Humans , Long QT Syndrome/chemically induced , Long QT Syndrome/diagnosis , Male , Melanoma/drug therapy , Melanoma/genetics , Melanoma/pathology , Middle Aged , Mutation , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/drug therapy , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Sulfonamides/administration & dosage , Sulfonamides/adverse effects , Sulfonamides/blood , Vomiting/chemically induced , Vomiting/diagnosis