Encorafenib/binimetinib induced severe liver injury in a melanoma patient: Case report and review of literature

Encorafenib/binimetinib combination is approved for BRAF mutated melanoma and is being increasing used. The landmark COLUMBUS trial reports <10% incidence of any liver related injury markers and no cases of severe liver injury from the regimen was noted. We report a 48-year-old male with severe life-threatening liver injury with the regimen. This injury was reproducible with re-introduction of the drug and vanished when the drugs were held. Dose reduction of encorafenib component of the combination allowed the regimen to be continued without liver damage. This highlights the only 2nd case reported with severe liver toxicity from the drug combination and proof-of-principle of using the lower dose in such scenario.