Photo- and heat- induced eruption secondary to tebentafusp and trametinib for advanced uveal melanoma

factors, and reversibility of BRAFi/MEKi-induced cardiotoxicity in a real-world setting.Methods: Patients with metastatic melanoma (n = 170) treated with Encorafenib/Binimetinib, Vemurafenib/Cobimetinib, or Dabrafenib/Trametinib at Aarhus and Odense University Hospital, Denmark from 2015 to 2023 were included.Cardiac function was assessed at baseline and every 3 months during treatment with either echocardiograms (ECHO) or multigated acquisition (MUGA) scans.Cardiotoxicity was defined as a reduction of LVEF by > 10 percentage points (pp) to an LVEF < 50% (Major cardiotoxicity) or a reduction of LVEF by > 15 pp but remaining > 50% (Minor cardiotoxicity).Results: Cardiotoxicity occurred in 21% of the patients, with 14% experiencing major cardiotoxicity.The mean time to LVEF decline was 187 days, with 92% of major cardiotoxicity cases occurring within the first year.Cardiotoxicity was reversible in 79% of patients following dose reduction, treatment pauses, heart failure therapy, or continued treatment with ongoing monitoring.Baseline cardiac arrhythmia (OR 13.67, p = 0.008) was identified as a risk factor for major cardiotoxicity.Conclusions: BRAFi/MEKi-induced cardiotoxicity is a significant but manageable complication, often reversible with timely interventions.Routine LVEF monitoring is recommended.However, the vast majority of major cardiotoxicities occurred during the first year of treatment, suggesting that discontinuation of routine LVEF monitoring after one year of BRAFi/MEKi-treatment is a safe strategy.Baseline cardiac arrhythmia may increase the risk of cardiotoxicity and warrants further study.