Optimizing Treatment of BRAFV600E-Mutant Metastatic NSCLC With Encorafenib and Binimetinib: A Practical Resource for Advanced Practice Providers.

Abstract

The BRAF V600E mutation aberrantly activates the mitogen-activated protein kinase (MAPK) pathway, subsequently resulting in uncontrolled cellular proliferation, survival, and dedifferentiation. Approximately 2% of patients with non-small cell lung cancer (NSCLC) have a BRAF V600E mutation. BRAF and MEK inhibitor combination therapy targets two kinases within the MAPK pathway. Encorafenib (Braftovi) and binimetinib (Mektovi) are potent oral inhibitors of BRAF and MEK, respectively. With the recent US Food and Drug Administration approval of encorafenib plus binimetinib, adult patients with BRAF V600E-mutated metastatic NSCLC have an additional treatment option. In the phase II PHAROS study, encorafenib plus binimetinib achieved the primary endpoint of objective response rate by independent review committee and exhibited a manageable safety profile in this patient population. This article provides an overview of the efficacy and safety of encorafenib plus binimetinib and uses a fictional patient case to illustrate the role of advanced practice providers in providing individualized patient care and identifying and managing adverse reactions.