Ocular Toxicities of Dabrafenib and Trametinib Combination Therapy

Primary Ocular Toxicities

The American Society of Clinical Oncology recommends that trametinib carries significant risk of serous retinopathy and requires mandatory ophthalmologic surveillance, while dabrafenib alone has minimal ocular toxicity—the combination therapy demands pretreatment eye examination and close monitoring at 2-3 weeks after initiation, then every 3-4 months 1, 2
Serous retinopathy (reversible) is the most notable ocular toxicity of trametinib monotherapy, requiring pretreatment ophthalmologic evaluation before initiating therapy 1, 2, 3
Recheck ophthalmologic examination 2-3 weeks after initiation is mandatory for patients on trametinib 1, 2
Ongoing monitoring every 3-4 months for the first year of treatment is recommended for patients on trametinib 1
Dabrafenib monotherapy has minimal to no specific ocular toxicity reported in guidelines from the National Comprehensive Cancer Network 4, 5, 6

A comprehensive ophthalmologic examination, including dilated fundoscopy, should be performed at baseline before starting therapy, as recommended by the American Academy of Ophthalmology 1, 2
Ophthalmologic examination at 2-3 weeks after initiation is critical to catch early serous retinopathy before it becomes symptomatic 1, 2
Every 3-4 months during the first year of treatment, patients should undergo ophthalmologic surveillance 1