My practice would be very similar to Krista’s. It is hard to predict who will get a fever and who won’t, but it seems like most patients do, at some point. On one of the early trials, we had a patient who struggled with fevers/pyrexia for the first few months and then remained fever-free for almost two years. At that point, the fevers came back and recurred frequently.
We do have several patients who require low dose steroids daily to avoid the fevers. In that scenario, if a fever did recur, I would hold dabrafenib/trametinib as Krista mentioned, temporarily increase the steroids and then resume once afebrile for at least 24 hours.
These are really tough!