Individualized MEK Inhibitor Dosing Strategies for NF1-PN

In this segment, the physicians discuss how MEK inhibitor dosing differs between pediatric and adult patients with NF1-associated plexiform neurofibromas. One physician explains that children are typically dosed using weight-based or body surface area–based calculations, whereas adults receive standard fixed dosing. However, both physicians emphasize that individualized dosing is often necessary regardless of age. They describe how starting at a lower-than-recommended dose can reduce early side effects—an approach particularly valuable for adults who may discontinue treatment if initial tolerability is poor. The physicians note that some patients achieve meaningful clinical benefits, including pain reduction, even at these reduced doses, eliminating the need to escalate therapy. They highlight that dose adjustments should reflect patient goals, symptom severity, and overall tolerability, especially because many adults are treated primarily for pain relief rather than rapid tumor progression. Both clinicians acknowledge that while these modified approaches deviate from strict guidelines, they are widely practiced and often improve adherence and quality of life.