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Cobimetinib is the MEK partner for vemurafenib, and the first drug approved for histiocytic neoplasms.
Cobimetinib is an allosteric MEK1/2 inhibitor given 60 mg once daily for 21 days of each 28-day cycle with the BRAF inhibitor vemurafenib, blocking two consecutive steps of the MAPK pathway. coBRIM (2015) showed PFS of 12.3 versus 7.2 months when it was added to vemurafenib in BRAF V600 melanoma. It is also approved with atezolizumab and vemurafenib (IMspire150, 2020), the first checkpoint plus targeted triplet in melanoma, and alone for histiocytic neoplasms (2022), the first drug approved for that group of rare diseases. Retinopathy, photosensitivity and creatine kinase elevation are the characteristic toxicities. Its melanoma use is limited by competition from dabrafenib-trametinib and encorafenib-binimetinib, and the value of the IMspire150 triplet remains debated. For a newcomer, cobimetinib is the MEK partner for vemurafenib and the go-to drug for histiocytosis.
Allosteric MEK1/2 inhibitor. Connects to BRAF.
1.Binds MEK1/2 allosterically
Source: www.accessdata.fda.gov/drugsatfda_docs/label/2022/206192s006lbl.pdf. Doses are for orientation; the current label governs.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA414 · SMC advice: cobimetinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Compare all products across the US, EU, UK, Japan, China and Australia →
| Region | Year | Indication |
|---|---|---|
| US | 2015 | BRAF V600 melanoma with vemurafenib |
| US | 2020 | With atezolizumab and vemurafenib in BRAF V600 melanoma |
| US | 2022 | Histiocytic neoplasms |
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The diagnostic and treatment rows on the Erdheim-Chester page follow these recommendations.
The treatment rows on the Rosai-Dorfman page, from watchful waiting to cobimetinib, follow these recommendations.
Query for this drug: (TITLE:"Cobimetinib" OR ABSTRACT:"Cobimetinib" OR TITLE:"Cotellic" OR ABSTRACT:"Cotellic") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cobimetinib, not a curated reading list.
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement), Erdheim-Chester disease, BRAF V600E (and V600K).
Shares Consensus recommendations for the diagnosis and clinical management of Rosai-Dorfman-Destombes disease, Rosai-Dorfman-Destombes disease, Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement).
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement), Erdheim-Chester disease, BRAF V600E (and V600K).
Shares IMblaze370, CheckMate 142, coBRIM, Melanoma (KEGG map).
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement), Erdheim-Chester disease, Rosai-Dorfman disease and other histiocytic neoplasms, Vemurafenib.
Shares Vemurafenib, BRAF V600-mutant melanoma, Advanced melanoma (unresectable stage III and stage IV), BRAF.
Shares Erdheim-Chester disease: consensus recommendations for evaluation, diagnosis and treatment in the molecular era, Erdheim-Chester disease, Craniopharyngioma, Erdheim-Chester disease, Rosai-Dorfman disease and other histiocytic neoplasms.
Shares Melanoma (KEGG map), BRAF V600E (and V600K), BRAF V600-mutant melanoma, Advanced melanoma (unresectable stage III and stage IV).