Encorafenib: BRAF Inhibitor for Melanoma & Colorectal Cancer
Encorafenib is a targeted cancer drug used in certain types of melanoma and colorectal cancer. It inhibits the mutated BRAF protein, thereby slowing tumor growth.
Things worth knowing about "Encorafenib"
Encorafenib is a targeted cancer drug used in certain types of melanoma and colorectal cancer. It inhibits the mutated BRAF protein, thereby slowing tumor growth.
What is Encorafenib?
Encorafenib is a targeted therapy agent belonging to the class of BRAF kinase inhibitors, used in oncology (cancer medicine). It was developed to block the abnormally active protein BRAF V600, which arises from a specific genetic mutation (BRAF V600E or BRAF V600K) and promotes uncontrolled cell growth. In the European Union and other markets, encorafenib is approved under the brand name Braftovi.
Indications (Approved Uses)
Encorafenib is approved for the following conditions:
- Melanoma with BRAF V600 mutation: Encorafenib is used in combination with the MEK inhibitor binimetinib in adults with unresectable or metastatic melanoma harboring a BRAF V600E or BRAF V600K mutation.
- Colorectal cancer (CRC) with BRAF V600E mutation: Encorafenib is used in combination with the EGFR inhibitor cetuximab in adults with metastatic colorectal cancer (mCRC) following prior therapy.
Mechanism of Action
Encorafenib is a selective inhibitor of the BRAF kinase. BRAF is a protein that functions as part of the MAPK/ERK signaling pathway, which regulates cell proliferation and survival.
In cancer patients carrying a BRAF V600 point mutation, this protein is permanently activated, driving uncontrolled tumor growth. Encorafenib binds with high affinity to the mutated BRAF kinase and inhibits its activity, thereby interrupting the growth signal and causing tumor cells to stop dividing or undergo cell death.
Combination with a MEK inhibitor (binimetinib) is important because BRAF inhibitors used alone can frequently lead to the development of resistance through the downstream MEK/ERK signaling pathway. Dual blockade delays this resistance and improves therapeutic response.
Dosage and Administration
Encorafenib is administered as hard capsules taken orally (by mouth). The recommended dose depends on the indication:
- Melanoma: 450 mg once daily in combination with binimetinib (45 mg twice daily).
- Colorectal cancer: 300 mg once daily in combination with cetuximab.
The capsules may be taken with or without food. Treatment is continued until disease progression or unacceptable toxicity. Dose modifications may be required in the event of adverse reactions.
Side Effects
Like all cancer medications, encorafenib can cause side effects. The most common include:
- Fatigue and tiredness
- Nausea, vomiting, and diarrhea
- Joint pain (arthralgia) and muscle pain (myalgia)
- Skin reactions (e.g., rash, photosensitivity)
- Headache and dizziness
- Elevated liver enzyme levels
- Increased blood pressure
More serious but less frequent side effects include:
- New skin tumors (e.g., cutaneous squamous cell carcinoma or new primary melanomas)
- Hemorrhage (bleeding)
- Cardiac rhythm disturbances (QT interval prolongation)
- Ocular complications (e.g., uveitis, visual disturbances)
- Deep vein thrombosis (DVT) and pulmonary embolism
Patients should undergo regular monitoring of the skin, eyes, liver function, and cardiac status throughout treatment.
Contraindications and Drug Interactions
Encorafenib must not be used in:
- Patients with known hypersensitivity to the active substance or any of the excipients.
- Cancer patients without a BRAF V600 mutation (no therapeutic benefit is expected and paradoxical activation of the MAPK pathway may promote tumor growth).
Important drug interactions exist with:
- Strong CYP3A4 inhibitors or inducers (e.g., certain antifungals, antiepileptics, rifampicin): these can significantly alter plasma levels of encorafenib.
- Substances that prolong the QT interval (e.g., certain antibiotics, antiarrhythmic agents): increased risk of cardiac arrhythmias.
References
- European Medicines Agency (EMA): Braftovi (Encorafenib) - Summary of Product Characteristics and European Public Assessment Report (EPAR). Available at: https://www.ema.europa.eu
- Dummer R. et al. - Encorafenib plus Binimetinib versus Vemurafenib or Encorafenib in Patients with BRAF-Mutant Melanoma (COLUMBUS): A Multicentre, Open-Label, Randomised Phase 3 Trial. The Lancet Oncology, 2018.
- Kopetz S. et al. - Encorafenib, Binimetinib, and Cetuximab in BRAF V600E-Mutated Colorectal Cancer. New England Journal of Medicine, 2019; 381:1632-1643.
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