Vemurafenib is a selective BRAF kinase inhibitor targeting mutated BRAF V600E, which leads to inhibition of the MAPK/ERK signaling pathway and tumor cell proliferation.

• Unresectable or metastatic melanoma with BRAF V600E mutation

• Erdheim-Chester Disease (ECD) with BRAF V600 mutation

Standard adult dose: 960 mg orally twice daily (4 tablets of 240 mg), taken approximately 12 hours apart, with or without food

• Common (≥30% in melanoma): Arthralgia, rash, alopecia, fatigue, photosensitivity, nausea, pruritus, skin papilloma

• Serious: Cutaneous squamous cell carcinoma (cuSCC), QT prolongation, hepatotoxicity, severe dermatologic reactions (e.g., SJS, TEN), hypersensitivity, uveitis, renal failure

None

• Risk of new primary malignancies (cuSCC, keratoacanthoma, melanoma)

• Tumor promotion in BRAF wild-type melanoma

• QT prolongation and potential arrhythmias

• Photosensitivity—avoid sun exposure

• Liver and renal toxicity—monitor liver enzymes and creatinine

• Serious skin reactions, hypersensitivity, ophthalmologic toxicity

• Radiation sensitization/recall

• Dupuytren's contracture and plantar fascial fibromatosis