Non-infectious febrile events occur in most patients and can occur at any time, with the majority of events occurring in the first 3 months. The median time to onset is 1 month.
Signs and symptoms include rigors, dehydration, hypotension, dizziness, weakness and fatigue.
It is important that patients are educated about the prodrome of fever and to cease dabrafenib upon symptom onset. Early intervention results in prompt resolution of events, usually within 24 hours of dose interruption. Paracetamol and NSAIDs may alleviate symptoms during pyrexia.
A septic work-up is not required for patients with uncomplicated pyrexia and without localizing infective symptoms.
Recommencement of dabrafenib can safely occur 24 hours after pyrexia resolution.
In cases of recurrent or severe pyrexia, an intermittent dosing regimen, and/or corticosteroids (prednisolone 10 to 25 mg daily) may be useful. Unlike other toxicities such as fatigue, dose reduction does not appear to reduce the risk of pyrexia recurrence and is best avoided.