Serious Adverse Event Caused by Combined Target Therapy

Combination therapy in the treatment of metastatic melanoma has more durable response rate rather than monotherapy. Although combined target therapy commonly causes a wide spectrum of adverse events, they are usually manageable. Toxic epidermal necrolysis represents severe mucocutaneous reaction, usually triggered by medications. Here we present a first case of toxic epidermal necrolysis induced by combined target therapy (vemurafenib plus cobimetinib). The case was observed in a young patient with BRAF mutant melanoma who was started on first-line metastatic immunotherapy with pembrolisumab. In conclusion, we emphasize the need to always compare drug efficacy with its potential adverse effects.