The emerging role of BRAF and MEK tyrosine-kinase inhibitors has shown new opportunities of treatment for patients with advanced melanoma and BRAF mutations. Its use is associated with some toxicities, as pyrexia, that clinicians may not be familiarized with. We present the case of a patient diagnosed with stage IV melanoma BRAF Val600E mutated who was started on dabrafenib and trametinib and developed three severe episodes of fever, hypotension and acute phase reactants elevation during the first 3 months of therapy, in the absence of microbiological demonstration of infection. The episodes were initially managed as a septic shock with broad-spectrum antibiotics and vasoactive drugs, while treatment with dabrafenib and trametinib was withheld. After two subsequent dose reduction of dabrafenib, the patient did not experience new episodes of fever.

中文翻译：

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达拉非尼-曲美替尼继发的急性期反应物极度升高和休克。

BRAF 和 MEK 酪氨酸激酶抑制剂的新兴作用为患有晚期黑色素瘤和 BRAF 突变的患者提供了新的治疗机会。它的使用与一些临床医生可能不熟悉的毒性有关，例如发热。我们介绍了一名诊断为 IV 期黑色素瘤 BRAF Val600E 突变的患者的病例，该患者开始服用达拉非尼和曲美替尼，在治疗的前 3 个月内，在没有微生物学证据的情况下，出现了 3 次严重发热、低血压和急性期反应物升高的症状的感染。这些发作最初是用广谱抗生素和血管活性药物治疗为感染性休克，同时停止使用达拉非尼和曲美替尼治疗。在随后两次减少达拉非尼剂量后，患者没有出现新的发烧症状。