Treatment with tovorafenib should be initiated and supervised by a qualified physician experienced in the use of anti-cancer medicinal products. Patient selection Before taking tovorafenib, patients must have confirmation of BRAF fusion or rearrangement, or BRAF V600 mutation assessed by a CE-marked in vitro diagnostic (IVD) medical device with the corresponding intended purpose.
If the CE-marked IVD is not available, confirmation of BRAF fusion or rearrangement, or BRAF V600 mutation should be assessed by an alternative validated test. Posology The recommended dose of tovorafenib based on body surface area (BSA) is 380 mg/m2 once weekly.
The maximum recommended dose is 600 mg once weekly (see Table 1). Ojemda may be administered as an immediate release tablet (see Table 1) or as an oral suspension (see tovorafenib 25 mg/ml powder for oral suspension SmPC). 3 m2 has not been established.
40 m2 600 mg Duration of treatment Treatment with tovorafenib should be continued once weekly until disease progression, loss of clinical benefit, or unacceptable toxicity. Missed or delayed doses If a dose is missed by 3 days or less, the missed dose should be taken as soon as possible, and the next dose should be taken on its regularly scheduled day.
If a dose is missed by more than 3 days, the missed dose should be skipped, and the next dose should be taken on its regularly scheduled day. A minimum of 4 days should occur between doses. Vomiting If vomiting occurs immediately after taking a dose, the dose should be repeated.
Dose modifications The management of adverse reactions may require dose reduction, treatment interruption or treatment discontinuation. The recommended dose reductions for adverse reactions for tovorafenib tablets are provided in Table 2.
40 m2 500 mg once weekly 400 mg once weekly The recommended dose modifications for adverse reactions for tovorafenib are in Table 3. 4 Table 3: Recommended dose modifications for adverse reactions Severity of ADRa Dose modificationb Haemorrhage and intratumoural haemorrhage • Intolerable Grade 2 • Grade 3 Withhold administration.
- If improved to Grade 0-1, resume at reduced dose. - If not improved, consider permanent discontinuation. • First occurrence of any Grade 4 Withhold administration. - If improved to Grade 0-1, resume at reduced dose. - If not improved, consider permanent discontinuation.
• Recurrent Grade 4 Permanent discontinuation. Skin toxicity, including photosensitivity • Intolerable Grade 2 • Grade 3 or 4 Withhold administration. - If improved to Grade 0‑1, resume at reduced dose. - If not improved, consider permanent discontinuation.
Liver related events • Grade 3 AST or ALT • Grade 3 bilirubin Withhold administration. If improved to Grade ≤ 2 or baseline resume as follows: - If laboratory abnormality resolves within 8 days, resume at the same dose. - If laboratory abnormality does not resolve within 8 days, resume at lower dosage.
• First occurrence of any Grade 4 Withhold administration. - If improved to Grade 0-1, resume at lower dosage. - If not improved, consider permanent discontinuation. • Recurrent Grade 4 Permanent discontinuation. Other adverse reactions • Intolerable Grade 2 • Grade 3 Withhold administration.
- If improved to Grade 0-1, resume at reduced dose. - If not improved, consider permanent discontinuation. • Grade 4 Withhold administration. - If improved to Grade 0-1, resume at reduced dose. - If not improved, consider discontinuation.
0. b See Table 2 for recommended dose reductions. 5x ULN and any AST). 2). Patients with moderately or severely abnormal liver function tests should be monitored carefully when treated with tovorafenib. 73 m2 calculated by Schwartz equation or MDRD equation) renal impairment.
2). Paediatric population Tovorafenib paediatric clinical experience is limited, particularly in the specific age range 6 months to 2 years. The safety and efficacy of tovorafenib in children below 6 months of age have not been established.
No data are available. Method of administration Ojemda is for oral use. The tablets should be swallowed whole with water and must not be chewed, cut, or crushed. 2). and should be taken at a regularly scheduled time once weekly. Ojemda should be administered to paediatric patients under adult supervision.
The film-coated tablets and powder for oral suspension may be used interchangeably (see tovorafenib powder for oral […]