Real-world data on cardiovascular effects of BRAF and MEK inhibitors remain limited. A prospective cohort study published in Journal of American College of Cardiology: CardioOncology evaluated the incidence and predictors of hypertension and cancer therapy–related cardiac dysfunction (CTRCD) in patients with melanoma.

The study enrolled 61 patients treated within a regional cancer network between March 2021 and March 2023. Baseline cardiotoxicity risk was assessed using European Society of Cardiology guideline–recommended tools. Cardiovascular evaluation was performed at baseline and at 4, 12, and 24 weeks, and included clinic and home blood pressure monitoring, echocardiography, stress perfusion cardiovascular magnetic resonance imaging, and blood biomarkers. CTRCD was defined according to International Cardio-Oncology Society criteria.

During follow-up, 28 patients (45.9%) developed hypertension and 28 (45.9%) developed CTRCD. Most CTRCD cases were mild (85.7%); 10.7% were moderate and 3.6% severe. All moderate or severe cases were detected by 4 weeks and showed partial reversibility. No low-risk patients developed moderate or severe CTRCD.

Patients with CTRCD had higher baseline NT-proBNP levels (median 109 pg/mL [Q1–Q3: –] vs 54 pg/mL [Q1–Q3: –]; P=0.047). No robust associations were identified between hypertension or cardiovascular magnetic resonance–derived myocardial or perfusion measures and incident CTRCD.

As the study has modest sample size and single-network design, findings are observational and require confirmation in larger studies. The findings support guideline-based baseline risk assessment and early surveillance echocardiography, particularly given that moderate or severe CTRCD occurred within 4 weeks.