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Comparing Toxicity Profiles of Immunotherapy Versus BRAF-Targeted Therapy in Melanoma

Ryan J. Sullivan, MD
Published Online:4:47 PM, Wed January 29, 2020

Ryan J. Sullivan, MD, an assistant professor of medicine at Harvard Medical School, compares the toxicity profiles of BRAF-targeted therapy and immunotherapy used for the treatment of patients with melanoma.
BRAF-targeted therapy is associated with significant toxicity that is virtually reversible with discontinuation or holding of treatment. However, immunotherapy is associated with immune-related toxicities that tend to require active treatment, which is often severe, to reverse, Sullivan says. Patients tend to feel better when the toxicities are resversed, but not all patients do.

Depending on the setting a physician is treating and whether the patients are receiving single-agent or combination therapy, there may be a difference in the rate of permanent toxicities, such as type 1 diabetes or thyroid, pituitary, and pancreatic endocrine toxicity. These types of toxicity require replacement of whatever the gland was making, and these are more commonly associated with immunotherapy than BRAF-targeted therapy.

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