{ "hits": { "hits": [ { "association": { "description": "BRAF Dabrafenib + Trametinib (BRAF inhibitor + MEK inhibitor) Responsive", "disease_labels_truncated": "cutaneous melanoma (disease)", "drug_labels": "DABRAFENIB,TRAMETINIB", "drug_labels_truncated": "DABRAFENIB", "environmentalContexts": [ { "approved_countries": [ "Canada", "US" ], "description": "DABRAFENIB", "id": "44462760", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Benzene and substituted derivatives", "direct-parent": "Sulfanilides", "kingdom": "Organic compounds", "subclass": "Sulfanilides", "superclass": "Benzenoids" }, "term": "DABRAFENIB", "toxicity": "LD50 in rats is > 2000 mg/kg [MSDS].\r\n\r\n\r\nThe most common side effects of Daretinib (Tafinlar) as a single agent include: hyperkeratosis, headache, pyrexia, arthralgia, papilloma, alopecia, and palmar-plantar erythrodysesthesia syndrome [FDA label].\r\n\r\nThe most common adverse reactions (\u226520%) for Tafinlar in combination with [DB08911] are pyrexia, chills, fatigue, rash, nausea, vomiting, diarrhea, abdominal pain, peripheral edema, cough, headache, arthralgia, night sweats, decreased appetite, constipation, and myalgia [FDA label].\r\n\r\nThe following is a list of toxicities that may occur with the combination of Daretinib and [DB08911]:\r\n\r\n**New primary malignancies**: These may occur when Tafinlar is administered as a single agent or in combination with [DB08911]. Monitor patients for new malignancies prior to initiation of therapy, while on therapy, and following discontinuation of TAFINLAR or the combination therapy. Tumor Promotion in BRAF Wild-Type Melanoma: Increased cell proliferation can occur with BRAF inhibitors [FDA label].\r\n\r\n**Hemorrhage:** Major hemorrhagic events can occur in patients receiving TAFINLAR in combination with trametinib. Monitor for signs and symptoms of bleeding [FDA label]. \r\n\r\n**Venous Thromboembolism**: Deep vein thrombosis and pulmonary embolism can occur in patients receiving the drug combination [FDA label].\r\n\r\n**Cardiomyopathy **: Assess LVEF before treatment with TAFINLAR in combination with trametinib, after one month of treatment, then every 2 to 3 months thereafter [FDA label]. \r\n\r\n**Ocular toxicities**: Perform an ophthalmologic evaluation for any visual disturbances [FDA label]. \r\n\r\n**Serious Febrile Reactions:** Incidence and severity of pyrexia are increased with TAFINLAR in combination with trametinib [FDA label]. \r\n\r\n**Serious Skin Toxicity:** Monitor for skin toxicities and for secondary infections. Discontinue for intolerable Grade 2, or Grade 3 or 4 rash not improving within 3 weeks despite the interruption of TAFINLAR [FDA label]. \r\n\r\n**Hyperglycemia:** Monitor serum glucose levels in patients with pre-existing diabetes or hyperglycemia [FDA label]. \r\n\r\n**Glucose-6-Phosphate Dehydrogenase Deficiency**: Closely monitor for hemolytic anemia [FDA label]. \r\n\r\n**Embryofetal Toxicity**: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus. TAFINLAR may render hormonal contraceptives less effective and an alternative method of contraception should be used [FDA label].", "usan_stem": "raf kinase inhibitors" }, { "approved_countries": [ "EU", "Canada", "US" ], "description": "TRAMETINIB", "id": "11707110", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Pyridopyrimidines", "direct-parent": "Pyridopyrimidines", "kingdom": "Organic compounds", "superclass": "Organoheterocyclic compounds" }, "term": "TRAMETINIB", "toxicity": "Most common adverse reactions (\u226520%) for trametinib include rash, diarrhea, and lymphedema [FDA label].\r\n\r\nThe most common adverse reactions (\u226520%) for Tafinlar in combination with Trametinib are pyrexia, chills, fatigue, rash, nausea, vomiting, diarrhea, abdominal pain, peripheral edema, cough, headache, arthralgia, night sweats, decreased appetite, constipation, and myalgia [FDA Label].\r\n\r\nThe following is a list of toxicities that may occur with the combination of Dabrafenib and Trametinib:\r\n\r\n**New primary malignancies**: These may occur when Tafinlar is administered as a single agent or in combination with Trametinib. Monitor patients for new malignancies prior to initiation of therapy, while on therapy, and following discontinuation of TAFINLAR or the combination therapy. Tumor Promotion in BRAF Wild-Type Melanoma: Increased cell proliferation can occur with BRAF inhibitors [FDA Label].\r\n\r\n**Hemorrhage**: Major hemorrhagic events can occur in patients receiving TAFINLAR in combination with trametinib. Monitor for signs and symptoms of bleeding [FDA Label].\r\n\r\n**Venous Thromboembolism**: Deep vein thrombosis and pulmonary embolism can occur in patients receiving the drug combination [FDA Label].\r\n\r\n**Cardiomyopathy**: Assess LVEF before treatment with TAFINLAR in combination with trametinib, after one month of treatment, then every 2 to 3 months thereafter [FDA Label].\r\n\r\n**Ocular toxicities**: Perform an ophthalmologic evaluation for any visual disturbances [FDA Label].\r\n\r\n**Serious Febrile Reactions**: Incidence and severity of pyrexia are increased with TAFINLAR in combination with trametinib [FDA Label].\r\n\r\n**Serious Skin Toxicity**: Monitor for skin toxicities and for secondary infections. Discontinue for intolerable Grade 2, or Grade 3 or 4 rash not improving within 3 weeks despite the interruption of TAFINLAR [FDA Label].\r\n\r\n**Hyperglycemia**: Monitor serum glucose levels in patients with pre-existing diabetes or hyperglycemia [FDA Label].\r\n\r\n**Glucose-6-Phosphate Dehydrogenase Deficiency**: Closely monitor for hemolytic anemia [FDA Label].\r\n\r\n**Embryofetal Toxicity**: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus. TAFINLAR may render hormonal contraceptives less effective and an alternative method of contraception should be used [FDA Label].", "usan_stem": "tyrosine kinase inhibitors: mitogen-activated protein (MAP) kinase inhibitors" } ], "evidence": [ { "description": "Responsive", "evidenceType": { "sourceName": "cgi" }, "info": { "publications": [ "https://www.google.com/#q=FDA" ] } } ], "evidence_label": "A", "evidence_level": 1, "phenotypes": [ { "description": "cutaneous melanoma (disease)", "family": "malignant endocrine neoplasm", "id": "MONDO:0005012", "source": "http://purl.obolibrary.org/obo/MONDO_0005012", "term": "cutaneous melanoma (disease)" } ], "publication_url": "https://www.google.com/#q=FDA", "response_type": "Responsive" }, "dev_tags": [], "diseases": "cutaneous melanoma (disease)", "drugs": "DABRAFENIB,TRAMETINIB", "evidence_label": "A", "feature_names": "BRAF (V600E,V600K)", "features": [ { "alt": "T", "biomarker_type": "mutant", "chromosome": "7", "description": "BRAF 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"geneSymbol": "BRAF", "hgvs": [ "NP_004324.2:p.Val600Glu", "XP_011514831.1:p.Val600Glu", "XP_016868048.1:p.V640E", "chr7:g.140753336A>T", "LRG_299:g.176429T>A", "NC_000007.12:g.140099605A>T", "ENSP00000288602.6:p.V600E", "CM000669.1:g.140453136A>T", "XP_016868048.1:p.Val640Glu", "NC_000007.13:g.140453136A>T", "ENSP00000420119.1:p.=", "XP_016868047.1:p.V640E", "NP_001341538.1:p.V600E", "NP_004324.2:p.V600E", "P15056:p.Val600Glu", "NG_007873.2:g.176429T>A", "LRG_299p1:p.V600E", "LRG_299p1:p.Val600Glu", "NG_007873.3:g.176429T>A", "ENSP00000288602.6:p.Val600Glu", "P15056:p.V600E", "XP_005250103.1:p.Val600Glu", "XP_005250102.1:p.Val600Glu", "ENSP00000418033.1:p.V28E", "XP_005250102.1:p.V600E", "XP_005250103.1:p.V600E", "XP_011514831.1:p.V600E", "NP_001341538.1:p.Val600Glu", "NC_000007.14:g.140753336A>T", "XP_011514832.1:p.=", "XP_016868047.1:p.Val640Glu", "chr7:g.140453136A>T", "ENSP00000418033.1:p.Val28Glu", "CM000669.2:g.140753336A>T" ], "hgvs_g_suffix": [ "g.140099605A>T", "g.140453136A>T", "g.140753336A>T", "g.176429T>A" ], "hgvs_p_suffix": [ "p.Val600Glu", "p.V640E", "p.V600E", "p.=", "p.V28E", "p.Val28Glu", "p.Val640Glu" ], "links": [ "http://reg.genome.network/refseq/RS000031", "http://reg.genome.network/refseq/RS000055", "http://myvariant.info/v1/variant/chr7:g.140453136A>T?assembly=hg19", "http://gnomad.broadinstitute.org/variant/7-140453136-A-T", "http://myvariant.info/v1/variant/chr7:g.140753336A>T?assembly=hg38", "http://reg.genome.network/allele/CA123643", "http://reg.genome.network/refseq/RS000007", "http://www.ncbi.nlm.nih.gov/snp/113488022", "http://www.ncbi.nlm.nih.gov/clinvar/variation/13961", "http://www.ncbi.nlm.nih.gov/clinvar/?term=29000[alleleid]", "http://cancer.sanger.ac.uk/cosmic/mutation/overview?id=476", "http://exac.broadinstitute.org/variant/7-140453136-A-T", "http://reg.genome.network/refseq/RS000682" ], "name": "BRAF:V600E", "provenance": [ "http://reg.genome.network/allele?hgvs=NC_000007.13%3Ag.140453136A%3ET" ], "provenance_rule": "from_source", "ref": "A", "referenceName": "GRCh37", "sequence_ontology": { "hierarchy": [ "SO:0000110", "SO:0002072", "SO:0001059" ], "name": "substitution", "root_name": "sequence_feature", "root_soid": "SO:0000110", "soid": "SO:1000002" }, "start": 140453136, "synonyms": [ "NP_004324.2:p.Val600Glu", "XM_017012559.1:c.1919T>A", "XM_005250046.1:c.1799T>A", "XM_011516530.1:c.1695-3918T>A", "XP_011514831.1:p.Val600Glu", "XM_005250045.1:c.1799T>A", "NR_148928.1:n.2897T>A", "LRG_299:g.176429T>A", "NM_004333.4:c.1799T>A", "NC_000007.12:g.140099605A>T", "XP_011514832.1:p.=", "CM000669.1:g.140453136A>T", "XP_016868048.1:p.Val640Glu", "ENST00000497784.1:n.1834T>A", "XR_001744857.1:n.1927T>A", "NC_000007.13:g.140453136A>T", "ENSP00000420119.1:p.=", "XM_011516529.1:c.1799T>A", "XR_927523.1:n.1703-3918T>A", "XM_017012558.1:c.1919T>A", "P15056:p.Val600Glu", "COSM476", "NM_001354609.1:c.1799T>A", "XR_001744858.1:n.1823-3918T>A", "NG_007873.2:g.176429T>A", "LRG_299t1:c.1799T>A", 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"response": "Responsive", "source": "cgi", "source_url": "https://www.cancergenomeinterpreter.org/biomarkers", "tags": [], "text_object": { "definition": "BRAF (V600E,V600K)", "id": "ga4gh:VT.NbXakwZcxGZSBKegMxVjeeR8BLvakpk3", "type": "Text" } }, { "association": { "description": "In a retrospective study of 44 relapsed melanoma patients harboring BRAF V600E or V600K (known BRAF inhibitor sensitizing mutations), MAPK pathway reactivation mechanisms were implicated in acquired resistance to BRAF inhibitor (vemurafenib or dabrafenib) monotherapy. The following MAPK pathway variants were found in progressive tumors with patient matched baseline tumors (some patients donated samples from multiple geographically/temporally distinct progressive tumors): NRAS mutations (G12D, G12R, G13R, Q61K, Q61R, Q61L) in 13/71 (18%) of progressive tumors, KRAS mutations (G12C, G12R, Q61H) in 5/71 (7%) of progressive tumors, mutant BRAF amplification (2-15 fold or 4-75 copies) in 11/57 (19%) of progressive tumors, mutant BRAF alternative splice variants (novel exon boundaries between 1/9, 1/11, 3/9) in 6/48 (13%) of progressive tumor RNA.", "disease_labels_truncated": "melanoma (disease)", "drug_labels": "DABRAFENIB,VEMURAFENIB", "drug_labels_truncated": "DABRAFENIB", "environmentalContexts": [ { "approved_countries": [ "Canada", "US" ], "description": "DABRAFENIB", "id": "44462760", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Benzene and substituted derivatives", "direct-parent": "Sulfanilides", "kingdom": "Organic compounds", "subclass": "Sulfanilides", "superclass": "Benzenoids" }, "term": "DABRAFENIB", "toxicity": "LD50 in rats is > 2000 mg/kg [MSDS].\r\n\r\n\r\nThe most common side effects of Daretinib (Tafinlar) as a single agent include: hyperkeratosis, headache, pyrexia, arthralgia, papilloma, alopecia, and palmar-plantar erythrodysesthesia syndrome [FDA label].\r\n\r\nThe most common adverse reactions (\u226520%) for Tafinlar in combination with [DB08911] are pyrexia, chills, fatigue, rash, nausea, vomiting, diarrhea, abdominal pain, peripheral edema, cough, headache, arthralgia, night sweats, decreased appetite, constipation, and myalgia [FDA label].\r\n\r\nThe following is a list of toxicities that may occur with the combination of Daretinib and [DB08911]:\r\n\r\n**New primary malignancies**: These may occur when Tafinlar is administered as a single agent or in combination with [DB08911]. Monitor patients for new malignancies prior to initiation of therapy, while on therapy, and following discontinuation of TAFINLAR or the combination therapy. Tumor Promotion in BRAF Wild-Type Melanoma: Increased cell proliferation can occur with BRAF inhibitors [FDA label].\r\n\r\n**Hemorrhage:** Major hemorrhagic events can occur in patients receiving TAFINLAR in combination with trametinib. Monitor for signs and symptoms of bleeding [FDA label]. \r\n\r\n**Venous Thromboembolism**: Deep vein thrombosis and pulmonary embolism can occur in patients receiving the drug combination [FDA label].\r\n\r\n**Cardiomyopathy **: Assess LVEF before treatment with TAFINLAR in combination with trametinib, after one month of treatment, then every 2 to 3 months thereafter [FDA label]. \r\n\r\n**Ocular toxicities**: Perform an ophthalmologic evaluation for any visual disturbances [FDA label]. \r\n\r\n**Serious Febrile Reactions:** Incidence and severity of pyrexia are increased with TAFINLAR in combination with trametinib [FDA label]. \r\n\r\n**Serious Skin Toxicity:** Monitor for skin toxicities and for secondary infections. Discontinue for intolerable Grade 2, or Grade 3 or 4 rash not improving within 3 weeks despite the interruption of TAFINLAR [FDA label]. \r\n\r\n**Hyperglycemia:** Monitor serum glucose levels in patients with pre-existing diabetes or hyperglycemia [FDA label]. \r\n\r\n**Glucose-6-Phosphate Dehydrogenase Deficiency**: Closely monitor for hemolytic anemia [FDA label]. \r\n\r\n**Embryofetal Toxicity**: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus. TAFINLAR may render hormonal contraceptives less effective and an alternative method of contraception should be used [FDA label].", "usan_stem": "raf kinase inhibitors" }, { "approved_countries": [ "EU", "Canada", "US" ], "description": "VEMURAFENIB", "id": "42611257", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Organooxygen compounds", "direct-parent": "Aryl-phenylketones", "kingdom": "Organic compounds", "subclass": "Carbonyl compounds", "superclass": "Organic oxygen compounds" }, "term": "VEMURAFENIB", "toxicity": "In the few toxicity reports, it has been shown an increased in the development of cutaneous squamous cell carcinomas or acceleration in pre-existant tumor growth.[FDA label]", "usan_stem": "raf kinase inhibitors" } ], "evidence": [ { "description": "Resistance", "evidenceType": { "id": "6400", "sourceName": "CIVIC" }, "info": { "publications": [ "http://www.ncbi.nlm.nih.gov/pubmed/24265155" ] } } ], "evidence_label": "B", 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"VA.MeK6m2rJ8zFgB8lYXUS3rwRyg-AAtDuF", "VA.oPMXWPoMvsYnQkWZ-uVX9Z_GFGbKKYQd" ], "gene_identifiers": [ { "ensembl_gene_id": "ENSG00000157764", "entrez_id": "673", "symbol": "BRAF" } ], "genes": [ "BRAF" ], "publications": "http://www.ncbi.nlm.nih.gov/pubmed/24265155", "response": "resistant", "source": "civic", "source_url": "https://civicdb.org/evidence/6400/summary", "tags": [], "text_object": { "definition": "intron 10 rearrangement", "id": "ga4gh:VT.KqxzD4IDqnLBVZWvUARxe4wUgY9Egp4q", "type": "Text" } }, { "association": { "description": "BRAF Pkinase_Tyr domain confers sensitivity to Dabrafenib, Panitumumab and Trametinib in patients with Neoplasm of colorectum", "disease_labels_truncated": "colorectal cancer,Neoplasm of gastrointestinal tract,Malignant tumor of digestive organ,Malignant neoplasm of abdomen,intestinal neoplasm,intestinal disease,Neoplasm by body site,digestive system cancer,Neoplasm of large intestine,Disorder of lower gastrointestinal tract,Disorder of gastrointestinal tract,Neoplasm of intra-abdominal organs,abdominal and pelvic region disorder,Neoplasm of abdomen,Disorder of body system,disease or disorder,Disorder of digestive organ,neoplastic disease or syndrome,Malignant neoplasm of gastrointestinal tract,disorder by anatomical region,Disorder of trunk,Disorder of abdomen,Neoplasm of digestive organ,Disorder of digestive tract,digestive system disease,cancer,Malignant neoplasm of intraabdominal organ,intestinal cancer,large intestine disease,Neoplasm and/or hamartoma,digestive system cancer,Neoplasm of digestive tract,Neoplasm of trunk,cancer", "drug_labels": "DABRAFENIB,PANITUMUMAB,TRAMETINIB", "drug_labels_truncated": "DABRAFENIB", "environmentalContexts": [ { "approved_countries": [ "Canada", "US" ], "description": "DABRAFENIB", "id": "44462760", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Benzene and substituted derivatives", "direct-parent": "Sulfanilides", "kingdom": "Organic compounds", "subclass": "Sulfanilides", "superclass": "Benzenoids" }, "term": "DABRAFENIB", "toxicity": "LD50 in rats is > 2000 mg/kg [MSDS].\r\n\r\n\r\nThe most common side effects of Daretinib (Tafinlar) as a single agent include: hyperkeratosis, headache, pyrexia, arthralgia, papilloma, alopecia, and palmar-plantar erythrodysesthesia syndrome [FDA label].\r\n\r\nThe most common adverse reactions (\u226520%) for Tafinlar in combination with [DB08911] are pyrexia, chills, fatigue, rash, nausea, vomiting, diarrhea, abdominal pain, peripheral edema, cough, headache, arthralgia, night sweats, decreased appetite, constipation, and myalgia [FDA label].\r\n\r\nThe following is a list of toxicities that may occur with the combination of Daretinib and [DB08911]:\r\n\r\n**New primary malignancies**: These may occur when Tafinlar is administered as a single agent or in combination with [DB08911]. Monitor patients for new malignancies prior to initiation of therapy, while on therapy, and following discontinuation of TAFINLAR or the combination therapy. Tumor Promotion in BRAF Wild-Type Melanoma: Increased cell proliferation can occur with BRAF inhibitors [FDA label].\r\n\r\n**Hemorrhage:** Major hemorrhagic events can occur in patients receiving TAFINLAR in combination with trametinib. Monitor for signs and symptoms of bleeding [FDA label]. \r\n\r\n**Venous Thromboembolism**: Deep vein thrombosis and pulmonary embolism can occur in patients receiving the drug combination [FDA label].\r\n\r\n**Cardiomyopathy **: Assess LVEF before treatment with TAFINLAR in combination with trametinib, after one month of treatment, then every 2 to 3 months thereafter [FDA label]. \r\n\r\n**Ocular toxicities**: Perform an ophthalmologic evaluation for any visual disturbances [FDA label]. \r\n\r\n**Serious Febrile Reactions:** Incidence and severity of pyrexia are increased with TAFINLAR in combination with trametinib [FDA label]. \r\n\r\n**Serious Skin Toxicity:** Monitor for skin toxicities and for secondary infections. Discontinue for intolerable Grade 2, or Grade 3 or 4 rash not improving within 3 weeks despite the interruption of TAFINLAR [FDA label]. \r\n\r\n**Hyperglycemia:** Monitor serum glucose levels in patients with pre-existing diabetes or hyperglycemia [FDA label]. \r\n\r\n**Glucose-6-Phosphate Dehydrogenase Deficiency**: Closely monitor for hemolytic anemia [FDA label]. \r\n\r\n**Embryofetal Toxicity**: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus. TAFINLAR may render hormonal contraceptives less effective and an alternative method of contraception should be used [FDA label].", "usan_stem": "raf kinase inhibitors" }, { "description": "PANITUMUMAB", "id": "CHEMBL1201827", "source": "http://rdf.ebi.ac.uk/terms/chembl", "term": "PANITUMUMAB", "usan_stem": "monoclonal antibodies" }, { "approved_countries": [ "EU", "Canada", "US" ], "description": "TRAMETINIB", "id": "11707110", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Pyridopyrimidines", "direct-parent": "Pyridopyrimidines", "kingdom": "Organic compounds", "superclass": "Organoheterocyclic compounds" }, "term": "TRAMETINIB", "toxicity": "Most common adverse reactions (\u226520%) for trametinib include rash, diarrhea, and lymphedema [FDA label].\r\n\r\nThe most common adverse reactions (\u226520%) for Tafinlar in combination with Trametinib are pyrexia, chills, fatigue, rash, nausea, vomiting, diarrhea, abdominal pain, peripheral edema, cough, headache, arthralgia, night sweats, decreased appetite, constipation, and myalgia [FDA Label].\r\n\r\nThe following is a list of toxicities that may occur with the combination of Dabrafenib and Trametinib:\r\n\r\n**New primary malignancies**: These may occur when Tafinlar is administered as a single agent or in combination with Trametinib. Monitor patients for new malignancies prior to initiation of therapy, while on therapy, and following discontinuation of TAFINLAR or the combination therapy. Tumor Promotion in BRAF Wild-Type Melanoma: Increased cell proliferation can occur with BRAF inhibitors [FDA Label].\r\n\r\n**Hemorrhage**: Major hemorrhagic events can occur in patients receiving TAFINLAR in combination with trametinib. Monitor for signs and symptoms of bleeding [FDA Label].\r\n\r\n**Venous Thromboembolism**: Deep vein thrombosis and pulmonary embolism can occur in patients receiving the drug combination [FDA Label].\r\n\r\n**Cardiomyopathy**: Assess LVEF before treatment with TAFINLAR in combination with trametinib, after one month of treatment, then every 2 to 3 months thereafter [FDA Label].\r\n\r\n**Ocular toxicities**: Perform an ophthalmologic evaluation for any visual disturbances [FDA Label].\r\n\r\n**Serious Febrile Reactions**: Incidence and severity of pyrexia are increased with TAFINLAR in combination with trametinib [FDA Label].\r\n\r\n**Serious Skin Toxicity**: Monitor for skin toxicities and for secondary infections. Discontinue for intolerable Grade 2, or Grade 3 or 4 rash not improving within 3 weeks despite the interruption of TAFINLAR [FDA Label].\r\n\r\n**Hyperglycemia**: Monitor serum glucose levels in patients with pre-existing diabetes or hyperglycemia [FDA Label].\r\n\r\n**Glucose-6-Phosphate Dehydrogenase Deficiency**: Closely monitor for hemolytic anemia [FDA Label].\r\n\r\n**Embryofetal Toxicity**: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus. TAFINLAR may render hormonal contraceptives less effective and an alternative method of contraception should be used [FDA Label].", "usan_stem": "tyrosine kinase inhibitors: mitogen-activated protein (MAP) kinase inhibitors" } ], "evidence": [ { "description": "BRAF Pkinase_Tyr domain confers sensitivity to Dabrafenib, Panitumumab and Trametinib in patients with Neoplasm of colorectum", "evidenceType": { "sourceName": "molecularmatch" }, "info": { "publications": [ "http://ascopubs.org/doi/abs/10.1200/jco.2015.33.15_suppl.103" ] } } ], "evidence_label": "B", "evidence_level": 2, "phenotypes": [ { "description": "colorectal cancer", "family": "intestinal cancer", "id": "MONDO:0005575", "source": "http://purl.obolibrary.org/obo/MONDO_0005575", "term": "colorectal cancer" }, { "description": "Neoplasm of gastrointestinal tract", "family": "Neoplasm of digestive tract", "id": "SNOMEDCT:126768004", "source": "SNOMEDCT", "term": "Neoplasm of gastrointestinal tract" }, { "description": "Malignant tumor of digestive organ", "family": "Neoplasm of digestive organ", "id": "SNOMEDCT:255077007", "source": "SNOMEDCT", "term": "Malignant tumor of digestive organ" }, { "description": "Malignant neoplasm of abdomen", "id": "MEDDRA:10025692", "source": "MEDDRA", "term": "Malignant neoplasm of abdomen" }, { "description": "intestinal neoplasm", "family": "digestive system neoplasm", "id": "MONDO:0021118", "source": "http://purl.obolibrary.org/obo/MONDO_0021118", "term": "intestinal neoplasm" }, { "description": "intestinal disease", "family": "disease or disorder", "id": "MONDO:0005020", "source": "http://purl.obolibrary.org/obo/MONDO_0005020", "term": "intestinal disease" }, { "description": "Neoplasm by body site", "family": "Disorder by body site", "id": "SNOMEDCT:127331007", "source": "SNOMEDCT", "term": "Neoplasm by body site" }, { "description": "digestive system cancer", "family": "cancer", "id": "MONDO:0002516", "source": "http://purl.obolibrary.org/obo/MONDO_0002516", "term": "digestive system cancer" }, { "description": "Neoplasm of large intestine", "family": "Disorder of large intestine", "id": "SNOMEDCT:126837005", "source": "SNOMEDCT", "term": "Neoplasm of large intestine" }, { "description": "Disorder of lower gastrointestinal tract", "family": "Disorder of gastrointestinal tract", "id": "SNOMEDCT:79787007", "source": "SNOMEDCT", "term": "Disorder of lower gastrointestinal tract" }, { "description": "Disorder of gastrointestinal tract", "family": "Disorder of digestive tract", "id": "SNOMEDCT:119292006", "source": "SNOMEDCT", "term": "Disorder of gastrointestinal tract" }, { "description": "Neoplasm of intra-abdominal organs", "family": "Neoplasm of abdomen", "id": "SNOMEDCT:126643005", "source": "SNOMEDCT", "term": "Neoplasm of intra-abdominal organs" }, { "description": "abdominal and pelvic region disorder", "family": "disease or disorder", "id": "MONDO:0044965", "source": "http://purl.obolibrary.org/obo/MONDO_0044965", "term": "abdominal and pelvic region disorder" }, { "description": "Neoplasm of abdomen", "family": "Neoplasm of trunk", "id": "SNOMEDCT:128050000", "source": "SNOMEDCT", "term": "Neoplasm of abdomen" }, { "description": "Disorder of body system", "family": "Disorder by body site", "id": "SNOMEDCT:362965005", "source": "SNOMEDCT", "term": "Disorder of body system" }, { "description": "disease or disorder", "family": "disposition", "id": "MONDO:0000001", "source": "http://purl.obolibrary.org/obo/MONDO_0000001", "term": "disease or disorder" }, { "description": "Disorder of digestive organ", "family": "Disorder of digestive system", "id": "SNOMEDCT:76712006", "source": "SNOMEDCT", "term": "Disorder of digestive organ" }, { "description": "neoplastic disease or syndrome", "family": "cell proliferation disorder", "id": "MONDO:0023370", "source": "http://purl.obolibrary.org/obo/MONDO_0023370", "term": "neoplastic disease or syndrome" }, { "description": "Malignant neoplasm of gastrointestinal tract", "family": "Neoplasm of gastrointestinal tract", "id": "SNOMEDCT:428905002", "source": "SNOMEDCT", "term": "Malignant neoplasm of gastrointestinal tract" }, { "description": "disorder by anatomical region", "family": "disease or disorder", "id": "MONDO:0024505", "source": "http://purl.obolibrary.org/obo/MONDO_0024505", "term": "disorder by anatomical region" }, { "description": "Disorder of trunk", "family": "Disorder by body site", "id": "SNOMEDCT:128121009", "source": "SNOMEDCT", "term": "Disorder of trunk" }, { "description": "Disorder of abdomen", "family": "Finding of abdomen", "id": "SNOMEDCT:118948005", "source": "SNOMEDCT", "term": "Disorder of abdomen" }, { "description": "Neoplasm of digestive organ", "family": "Disorder of digestive organ", "id": "SNOMEDCT:254532005", "source": "SNOMEDCT", "term": "Neoplasm of digestive organ" }, { "description": "Disorder of digestive tract", "family": "Disorder of digestive system", "id": "SNOMEDCT:84410009", "source": "SNOMEDCT", "term": "Disorder of digestive tract" }, { "description": "digestive system disease", "family": "disease or disorder", "id": "MONDO:0004335", "source": "http://purl.obolibrary.org/obo/MONDO_0004335", "term": "digestive system disease" }, { "description": "cancer", "family": "neoplasm (disease)", "id": "MONDO:0004992", "source": "http://purl.obolibrary.org/obo/MONDO_0004992", "term": "cancer" }, { "description": "Malignant neoplasm of intraabdominal organ", "family": "Malignant neoplasm of abdomen", "id": "SNOMEDCT:448882009", "source": "SNOMEDCT", "term": "Malignant neoplasm of intraabdominal organ" }, { "description": "intestinal cancer", "family": "cancer", "id": "MONDO:0005814", "source": "http://purl.obolibrary.org/obo/MONDO_0005814", "term": "intestinal cancer" }, { "description": "large intestine disease", "family": "disease or disorder", "id": "MONDO:0024634", "source": "http://purl.obolibrary.org/obo/MONDO_0024634", "term": "large intestine disease" }, { "description": "Neoplasm and/or hamartoma", "family": "Proliferative mass", "id": "SNOMEDCT:400177003", "source": "SNOMEDCT", "term": "Neoplasm and/or hamartoma" }, { "description": "digestive system cancer", "family": "cancer", "id": "MONDO:0002516", "source": "http://purl.obolibrary.org/obo/MONDO_0002516", "term": "digestive system cancer" }, { "description": "Neoplasm of digestive tract", "family": "Disorder of digestive tract", "id": "SNOMEDCT:128415001", "source": "SNOMEDCT", "term": "Neoplasm of digestive tract" }, { "description": "Neoplasm of trunk", "family": "Neoplasm by body site", "id": "SNOMEDCT:126637008", "source": "SNOMEDCT", "term": "Neoplasm of trunk" }, { "description": "cancer", "family": "neoplasm (disease)", "id": "MONDO:0004992", "source": "http://purl.obolibrary.org/obo/MONDO_0004992", "term": "cancer" } ], "publication_url": "http://ascopubs.org/doi/abs/10.1200/jco.2015.33.15_suppl.103", "response_type": "1B", "variant_name": [] }, "dev_tags": [ "no-so" ], "diseases": "colorectal 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substituted derivatives", "direct-parent": "Anthranilamides", "kingdom": "Organic compounds", "subclass": "Benzoic acids and derivatives", "superclass": "Benzenoids" }, "term": "COBIMETINIB", "toxicity": "The most common adverse effects (>20%) for cobimetinib are diarrhea, photosensitivity reactions, nausea, fever and vomiting.", "usan_stem": "tyrosine kinase inhibitors: mitogen-activated protein (MAP) kinase inhibitors" }, { "approved_countries": [ "EU", "Canada", "US" ], "description": "TRAMETINIB", "id": "11707110", "source": "http://rdf.ncbi.nlm.nih.gov/pubchem/compound", "taxonomy": { "class": "Pyridopyrimidines", "direct-parent": "Pyridopyrimidines", "kingdom": "Organic compounds", "superclass": "Organoheterocyclic compounds" }, "term": "TRAMETINIB", "toxicity": "Most common adverse reactions (\u226520%) for trametinib include rash, diarrhea, and lymphedema [FDA label].\r\n\r\nThe most common adverse reactions (\u226520%) for Tafinlar in combination with Trametinib are pyrexia, chills, fatigue, rash, nausea, vomiting, diarrhea, abdominal pain, peripheral edema, cough, headache, arthralgia, night sweats, decreased appetite, constipation, and myalgia [FDA Label].\r\n\r\nThe following is a list of toxicities that may occur with the combination of Dabrafenib and Trametinib:\r\n\r\n**New primary malignancies**: These may occur when Tafinlar is administered as a single agent or in combination with Trametinib. Monitor patients for new malignancies prior to initiation of therapy, while on therapy, and following discontinuation of TAFINLAR or the combination therapy. Tumor Promotion in BRAF Wild-Type Melanoma: Increased cell proliferation can occur with BRAF inhibitors [FDA Label].\r\n\r\n**Hemorrhage**: Major hemorrhagic events can occur in patients receiving TAFINLAR in combination with trametinib. Monitor for signs and symptoms of bleeding [FDA Label].\r\n\r\n**Venous Thromboembolism**: Deep vein thrombosis and pulmonary embolism can occur in patients receiving the drug combination [FDA Label].\r\n\r\n**Cardiomyopathy**: Assess LVEF before treatment with TAFINLAR in combination with trametinib, after one month of treatment, then every 2 to 3 months thereafter [FDA Label].\r\n\r\n**Ocular toxicities**: Perform an ophthalmologic evaluation for any visual disturbances [FDA Label].\r\n\r\n**Serious Febrile Reactions**: Incidence and severity of pyrexia are increased with TAFINLAR in combination with trametinib [FDA Label].\r\n\r\n**Serious Skin Toxicity**: Monitor for skin toxicities and for secondary infections. Discontinue for intolerable Grade 2, or Grade 3 or 4 rash not improving within 3 weeks despite the interruption of TAFINLAR [FDA Label].\r\n\r\n**Hyperglycemia**: Monitor serum glucose levels in patients with pre-existing diabetes or hyperglycemia [FDA Label].\r\n\r\n**Glucose-6-Phosphate Dehydrogenase Deficiency**: Closely monitor for hemolytic anemia [FDA Label].\r\n\r\n**Embryofetal Toxicity**: Can cause fetal harm. Advise females of reproductive potential of potential risk to a fetus. TAFINLAR may render hormonal contraceptives less effective and an alternative method of contraception should be used [FDA Label].", "usan_stem": "tyrosine kinase inhibitors: mitogen-activated protein (MAP) kinase inhibitors" } ], "evidence": [ { "description": "3A", "evidenceType": { "id": "BRAF-Ovarian Cancer", "sourceName": "oncokb" }, "info": { "publications": [ "http://www.ncbi.nlm.nih.gov/pubmed/23890088", "http://www.ncbi.nlm.nih.gov/pubmed/26324360", "http://www.ncbi.nlm.nih.gov/pubmed/24345920" ] } } ], "evidence_label": "C", "evidence_level": 3, "phenotypes": [ { "description": "ovarian cancer", "family": "cancer", "id": "MONDO:0008170", "source": "http://purl.obolibrary.org/obo/MONDO_0008170", "term": "ovarian cancer" } ], "publication_url": "http://www.ncbi.nlm.nih.gov/pubmed/23890088", "response_type": "sensitive", "source_link": "http://oncokb.org/#/gene/BRAF/variant/Fusions", "variant_name": "Fusions" }, "dev_tags": [ "no-so" ], "diseases": "ovarian cancer", "drugs": 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], "genes": [ "BRAF" ], "publications": "http://www.ncbi.nlm.nih.gov/pubmed/22798288,http://www.ncbi.nlm.nih.gov/pubmed/24933606,http://www.ncbi.nlm.nih.gov/pubmed/26643848", "response": null, "source": "oncokb", "source_url": "http://oncokb.org/#/gene/BRAF/variant/L597S", "tags": [], "text_object": { "definition": "BRAF L597S", "id": "ga4gh:VT.wp-LLD0-6VYiDAhlGwGJQw0RcKSmPZRh", "type": "Text" } } ], "total": 105 } }