ArticleJACC. CardioOncology2025
Prospective Evaluation of the Cardiovascular Effects of BRAF and MEK Inhibitors in Patients With Melanoma.
Article in JACC. CardioOncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Systemic Melanoma Therapy in Patients with Pre-Existing Heart Failure: An HF-Centered Decision Framework and Critical Narrative Review.Journal of clinical medicine · 2026Review
- Artificial intelligence-enhanced electrocardiography for prediction of cancer therapy-related cardiac dysfunction.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Time to Personalize Surveillance for Cancer Therapy-Related Cardiac Dysfunction in HER2-Targeted Therapy: One Size Does Not Fit All.Current heart failure reports · 2026Review
- The MEK inhibitor trametinib incurs mitochondrial injury and induces innate immune responses in the mouse heart.Science advances · 2026Article
- Heart failure induced by cancer therapies: focus on targeted agents, mechanisms, risk prediction, and clinical management.Frontiers in pharmacology · 2026Review
- Cardiovascular Surveillance in BRAF/MEK Inhibitor Therapy: Early Lessons from Prospective Data.JACC. CardioOncology · 2025Article
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRapidly accelerated fibrosarcoma B-type (BRAF) and MEK inhibitors have revolutionized outcomes for patients with BRAF-mutated melanoma. However, they are associated with cardiovascular adverse effects. The real-world incidence and risk factors for these effects are poorly described.
objectivesThe aim of this study was to characterize the incidence and risk factors for BRAF inhibitor- and MEK inhibitor-associated hypertension and cancer therapy-related cardiac dysfunction (CTRCD) in a real-world setting.
methodsA prospective, longitudinal, cohort study was undertaken among patients with melanoma treated with BRAF and MEK inhibitors in a regional cancer network (March 2021 to March 2023). Baseline cardiotoxicity risk stratification was assessed using the European Society of Cardiology cardio-oncology guideline-recommended tool. Comprehensive cardiovascular assessment was performed at baseline and at 4, 12, and 24 weeks, including home and clinic blood pressure, echocardiography, stress perfusion cardiovascular magnetic resonance imaging and blood biomarkers. CTRCD was defined using International Cardio-Oncology Society definitions.
resultsA total of 61 participants were enrolled. Twenty-eight participants (45.9%) developed hypertension and 45.9% developed CTRCD: 24 (85.7%) mild, 3 (10.7%) moderate, and 1 (3.6%) severe. All moderate or severe CTRCD was evident by 4 weeks and at least partially reversible. No patient at low baseline risk developed moderate or severe CTRCD. Patients with CTRCD had higher median baseline N-terminal pro-B-type natriuretic peptide compared with those without (109 pg/mL [Q1-Q3: 51-380 pg/mL] vs 54 pg/mL [Q1-Q3: 29-149 pg/mL]; P = 0.047). There were no robust associations between hypertension nor cardiovascular magnetic resonance imaging-derived myocardial or perfusion characteristics and incident CTRCD.
conclusionsBRAF inhibitor- and MEK inhibitor-associated hypertension and CTRCD are common. The present results reinforce the utility of baseline cardiotoxicity risk stratification, including assessment of N-terminal pro-B-type natriuretic peptide. Future guidelines should consider recommending early surveillance echocardiography for higher risk patients.
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