Binimetinib is a MEK inhibitor primarily used for the treatment of metastatic melanoma and non-small cell lung cancer, and should be used in combination with Conafenib. The medication should strictly follow the dosage specifications and pay attention to adjusting for special populations and managing side effects. Here is the specific information:

1. Usage and dosage

The recommended dosage for adults is 45 milligrams per oral dose, once every 12 hours, until disease progression or unacceptable toxic reactions occur. Swallow the whole piece, do not crush or chew.

(1) Dose adjustment

If the standard dose cannot be tolerated, it can be reduced to 30 milligrams per dose; If intolerance persists, the medication needs to be permanently discontinued. The recommended dose for patients with moderate or severe liver dysfunction is 30 milligrams per dose.

2 Resistance mechanisms

Bimetinib blocks the MAPK pathway by inhibiting MEK1/2, but tumors may develop resistance through alternative pathways such as BRAF amplification or mutation, NRAS activation, etc. Combination therapy can delay the occurrence of drug resistance.

3 Precautions

(1) Special populations

Prohibited during pregnancy, feeding should be suspended during lactation. Women of childbearing age need to use contraception for 30 days after the last dose. Elderly individuals and those with mild liver/kidney dysfunction do not require dose adjustment.

(2) Adverse reaction management

Serious reactions such as cardiomyopathy, venous thrombosis, and ocular toxicity need to be monitored. If left ventricular dysfunction or interstitial lung disease occurs, treatment should be immediately interrupted and evaluated for reduction.

(3) Drug interactions

Combined use with strong CYP3A4 inhibitors may increase exposure and require close monitoring of toxicity. Avoid long-term use with proton pump inhibitors as it may reduce efficacy.