Would you discontinue dabrafenib/trametinib in a patient with BRAF mutant metastatic lung cancer if you see mild cardiomyopathy which could be related to the drugs?

This is a good question and a clinical scenario that I just recently ran into. The main question relates to the degree of LVEF change and whether the patient is symptomatic or not. It is not that uncommon overall. In the phase 2 trial of dabrafenib and trametinib that led to approval of this regimen in BRAF V600E positive NSCLC, the incidence of decreased LVEF was 9% (6% Grade 3). However, this was a very small phase 2 study. Looking at the published data from patients with melanoma, in the land...