Binimetinib is used for BRAF mutation-positive melanoma and non-small cell lung cancer, and medication use in special populations requires individualized assessment. The following briefly describes three aspects: pregnancy and lactation, hepatic and renal function, and elderly and pediatric patients.

I. Pregnancy, lactation, and reproductive-related populations

1. Use during pregnancy

Based on animal studies and its mechanism of action, binimetinib can cause fetal harm. Use in pregnant women may cause embryotoxicity and miscarriage. Women of reproductive potential should confirm that they are not pregnant before treatment and use effective contraception during treatment and for at least 30 days after the last dose.

2. Use during lactation

It is not yet known whether binimetinib passes into human milk. Because serious adverse reactions may occur in a breastfed infant, breastfeeding should be stopped during treatment and for 3 days after the last dose.

3. Women of reproductive potential and men

Female patients of reproductive potential need a pregnancy test before treatment. If pregnancy occurs or is suspected during treatment, the doctor should be informed immediately. There are currently no special contraceptive requirements for male patients, but those with reproductive plans should consult a doctor.

II. Patients with hepatic and renal impairment

1. Mild hepatic impairment

No dose adjustment is needed for patients with mild hepatic impairment. Liver function should still be monitored regularly during treatment.

2. Moderate to severe hepatic impairment

For patients with moderate or severe hepatic impairment, the recommended dose of binimetinib is reduced to 30 mg twice daily. Drug exposure may be increased in such patients, and adverse reactions should be closely observed.

3. Renal impairment

No dose adjustment is needed for patients with severe renal impairment. There are currently no dose adjustment recommendations for mild or moderate renal impairment. Changes in renal function should be monitored during treatment.

4. Combination medication reminder

Binimetinib is often used in combination with encorafenib. If encorafenib is permanently discontinued due to adverse reactions, binimetinib should also be discontinued. Liver function monitoring should continue throughout treatment.

III. Elderly and pediatric patients

1. Elderly patients

No dose adjustment based on age is needed for elderly patients. Existing data do not show overall differences in safety or effectiveness between elderly and younger patients. However, elderly patients often have other diseases or medications, so monitoring should be strengthened.

2. Pediatric patients

The safety and effectiveness of binimetinib in pediatric patients have not been established. It is not recommended for children.

3. Other special considerations

Left ventricular ejection fraction, eye condition, and blood pressure should be assessed before treatment. During treatment, the heart, vision, lungs, and signs of bleeding should be monitored regularly. If serious adverse reactions occur, the medication should be paused, reduced, or permanently discontinued as instructed by the doctor.