Vemurafenib (Zelboraf®)

OncoLink
Last Modified: January 14, 2012

Share article


Pronounced: VEM-ue-RAF-e-nib
Classification: Kinase Inhibitor

About Vemurafenib

BRAF is a protein kinase that plays a role in regulating genes that are responsible for cell replication and survival. It is estimated that 50% of melanomas contain an abnormal form of BRAF (also called a mutation). This mutated form of BRAF appears to promote overgrowth of these cancer cells. Vemurafenib works by blocking the actions of the abnormal BRAF, inhibiting cell replication and potentially causing cell death.

How to Take Vemurafenib

Vemurafenib is given in a tablet form, with the typical dose being 960 milligrams (made up of 4 240mg tablets) taken twice a day. Vemurafenib tablets should be taken with a glass of water and should not be crushed, broken or chewed. If you miss a dose, you can take the dose up to 4 hours before the next dose. Do not take two doses at once to make up for a missed dose.

BRAF Testing

Because this medication only works in melanoma that has a mutated form of BRAF, this abnormality must be tested for prior to starting the medication to identify patients appropriate for therapy. In order to test for mutated BRAF, a sample of the tumor is sent to a special laboratory that performs this test.

Possible Side Effects of Vemurafenib

There are a number of things you can do to manage the side effects of Vemurafenib. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Sun Sensitivity

Your skin will be more sensitive to the sun, which can result in severe sunburn or rash. Sun sensitivity can last even after vemurafenib is stopped. Avoid the sun between 10-2pm, when it is strongest. Wear sunscreen (at least SPF 15) and lip balm everyday, wear sunglasses and long sleeves/pants to protect your skin.

Rash and Allergic Reactions

Some patients can develop a reaction to vemurafenib, which can include rash, skin redness, or a serious allergic reaction causing difficulty breathing. If you have any side effects while taking this medication, be sure to inform you oncology team right away.

Nausea and/or Vomiting

Take anti-nausea medications as prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.

Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Muscle or Joint Pain/Aches

Your doctor or nurse can recommend medication and other strategies to relive pain. Also view OncoLink's page on pain management.

Fatigue

While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink's section on fatigue for helpful tips on dealing with this side effect.

Loss or Thinning of Scalp and Body Hair (Alopecia)

Your hair may become thin, brittle, or may fall out. This typically begins two to three weeks after treatment starts. This hair loss can be all body hair, including pubic, underarm, legs/arms, eyelashes, and nose hairs. The use of scarves, wigs, hats and hairpieces may help. Hair generally starts to regrow soon after treatment is completed. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun. Read more on alopecia.

Decrease in Appetite

Visit OncoLink's section on Nutrition for tips on dealing with this side effect. Ask your nurse about nutritional counseling services.

  • Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.
  • If you are not eating enough, nutritional supplements may help.
  • You may experience a metallic taste or dislike foods or beverages that you liked before receiving chemotherapy. These symptoms can last up to several months.
  • Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products and fish without a strong smell.
  • Flavor meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary. Bacon, ham and onion can also add flavor to vegetables.

New Skin Cancer

In clinical trials, some patients developed a new skin cancer (melanoma or squamous cell cancer). You should have skin examinations every 2 months while on therapy and for 6 months after the medication has been stopped. Check your own skin regularly and report any changes to your healthcare provider.

Heart Issues

Vemurafenib can cause a heart problem called QT prolongation, which can lead to heart dangerous arrhythmias (irregular rhythms). Your healthcare provider will monitor for this problem with periodic ECGs (electrocardiogram) and lab work to evaluate electrolyte levels.

Eye Issues

In clinical trials, several patients developed a condition called uveitis, which is a swelling or irritation of the middle layer of the eye. Symptoms of this condition include blurry vision, "floaters" (dark spots in the field of vision), eye redness or pain and sensitivity to light. If you develop any of these symptoms, notify your healthcare provider right away.


News
And, vemurafenib improves survival in melanoma patients with BRAF V600E mutation

Jun 7, 2011 - The addition of ipilimumab to dacarbazine appears to improve survival in patients with previously untreated metastatic melanoma, and vemurafenib appears to improve survival in patients with metastatic melanoma and the BRAF V600E mutation, according to two studies published online June 5 in the New England Journal of Medicine to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.



I Wish You Knew

Skin cancer 101

View More



Blogs and Web Chats

OncoLink Blogs give our readers a chance to react to and comment on key cancer news topics and provides a forum for OncoLink Experts and readers to share opinions and learn from each other.




OncoLink OncoPilot

Facing a new cancer diagnosis or changing the course of your current treatment? Let our cancer nurses help you through!

Learn More



OncoLink Cancer Treatment and Resources