During the clinical trials, fevers with BRAK/MEK inhibitor therapy occurred in about 54% of patients. Fevers usually start after about 30 days of treatment, lasting 2-3 days, and typically improving after 6 months. Your patient must contact the oncology team if they begin to experience fevers. For low-grade fevers of 99-101°F, they can take antipyretics as directed by the provider. Also make sure your patient is drinking plenty of water. For a fever higher than 101°F, the oncology team member most likely will hold the BRAF inhibitor, and if the patient’s temperature is higher than 104°F, he/she will hold both medications and see the patient in clinic. The patient might need supportive care such as IV hydration and to begin low dose prednisone as recommended by the prescribing information. Some patients might need a dose holiday and dose reduction until fevers resolve. Keeping well hydrated is very important, especially with higher temperatures, to avoid dehydration.

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