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Systemic Anti-Cancer Therapy Regimen Library

Home > SKIN Melanoma Metastatic - cOBIMEtinib and vemurafenib

SKIN Melanoma Metastatic - cOBIMEtinib and vemurafenib

Treatment Overview

Cycle 1 (and all further cycles) - 28 days

Cycle length:
28

Cycle details

Cycle 1 (and all further cycles) - 28 days

Medication Dose Route Days Max Duration
cOBIMEtinib 60 mg Once daily oral administration 1 to 21
vemurafenib 960 mg Twice daily oral administration 1 to 28
loperamide 2 mg oral administration 1

Full details

Cycle 1 (and all further cycles) - 28 days

Day: 1

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 3

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 4

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 5

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 6

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 7

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 8

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 9

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 10

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 11

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 12

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 13

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 14

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 15

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 16

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 17

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 18

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 19

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 20

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 21

Medication Dose Route Max duration Details
cOBIMEtinib 60 mg Once daily oral administration
Instructions:
Avoid grapefruit and its juice.
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 22

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 23

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 24

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 25

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 26

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 27

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Day: 28

Medication Dose Route Max duration Details
vemurafenib 960 mg Twice daily oral administration
Instructions:
Take each dose approximately 12 hours apart on an empty stomach—one hour before OR two hours after food. Take with a glass of water and swallow whole, do not crush or chew.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Minimal

References

Long, G. V., D. Stroyakovskiy, H. Gogas, et al. 2014. "Combined BRAF and MEK inhibition versus BRAF inhibition alone in melanoma." N Engl J Med 371(20):1877-1888 , PMID: 25265492

Robert, C., B. Karaszewska, J. Schachter, et al. 2014. "Improved Overall Survival in Melanoma with Combined Dabrafenib and Trametinib." N Engl J Med. , PMID: 25399551

Larkin, J., P. A. Ascierto, B. Dreno, et al. 2014. "Combined vemurafenib and cobimetinib in BRAF-mutated melanoma." N Engl J Med 371(20):1867-1876 , PMID: 25265494

Ascierto, P. A., G. A. McArthur, B. Dreno, et al. 2016. "Cobimetinib combined with vemurafenib in advanced BRAF(V600)-mutant melanoma (coBRIM): updated efficacy results from a randomised, double-blind, phase 3 trial." Lancet Oncol 17(9):1248-1260 , PMID: 27480103

Dreno, B., P. A. Ascierto, V. Atkinson, et al. 2018. "Health-related quality of life impact of cobimetinib in combination with vemurafenib in patients with advanced or metastatic BRAF(V600) mutation-positive melanoma." Br J Cancer 118(6):777-784 , PMID: 29438370

Roche Products (New Zealand) Limited. Cotellic New Zealand Data Sheet 22 July 2020. https://www.medsafe.govt.nz/profs/Datasheet/c/cotellictab.pdf (Accessed 14 June 2021).

Roche Products (New Zealand) Limited. Zelboraf New Zealand Data Sheet 10 June 2020. https://www.medsafe.govt.nz/profs/Datasheet/z/zelboraftab.pdf (Accessed 14 June 2021).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.