Cobimetinib is an oral small molecule targeted drug that selectively inhibits MEK kinase, blocks MAPK signaling pathway, and thus inhibits tumor cell proliferation. It is usually combined with Vemurafenib for the treatment of unresectable or metastatic melanoma carrying BRAFV600E or V600K mutations.

1. Usage and dosage

1.1 Standard dose: The recommended dose is 60mg per dose (i.e. three 20mg tablets), once daily, orally.

1.2 Medication cycle: Every 28 days is a treatment cycle, with continuous medication for the first 21 days and discontinuation for 7 days thereafter.

1.3 Usage: It is recommended to take it with meals or on an empty stomach at a fixed time every day. The pill should be swallowed whole and should not be crushed or chewed. If the missed dose is more than 12 hours away from the next medication, it should be taken as soon as possible; If it is less than 12 hours, skip the missed dose.

1.4 Dose adjustment: If severe or intolerable toxic reactions occur (such as skin reactions, cardiac or muscle toxicity), the medication should be temporarily suspended, reduced (to 40mg or 20mg), or permanently discontinued.

2. Efficacy performance

2.1 Core Function: Combined with Verofenib, it is used to treat advanced melanoma with BRAFV600 mutation, which can significantly delay tumor growth.

2.2 Treatment prerequisite: Before medication, the BRAFV600E or V600K mutation status must be determined through certified testing methods.

3. Precautions

3.1 Cardiac monitoring: may cause a decrease in left ventricular ejection fraction. Regular cardiac ultrasound examinations are required before and during treatment.

3.2 Muscle injury: can cause elevated serum creatine kinase and muscle pain. It is recommended to regularly monitor CPK levels.

3.3 Visual and Skin Toxicity: May cause visual impairment or severe rash. Seek medical attention immediately if there are changes in vision or extensive skin reactions.

3.4 Avoid potent CYP3A4 inhibitors: This drug is mainly metabolized by the CYP3A4 enzyme, and the combination of potent inhibitors can significantly increase its blood drug concentration and increase the risk of toxic side effects.