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达拉非尼联合曲美替尼治疗 BRAF V600 阳性的晚期或转移性非小细胞肺癌:临床证据和经验。

Dabrafenib in combination with trametinib in the treatment of patients with BRAF V600-positive advanced or metastatic non-small cell lung cancer: clinical evidence and experience.

机构信息

Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.

Department of Internal medicine, Cleveland Clinic, Cleveland, OH, USA.

出版信息

Ther Adv Respir Dis. 2018 Jan-Dec;12:1753466618767611. doi: 10.1177/1753466618767611.

Abstract

Mutations in the BRAF oncogene are found in 2-4% of all non-small cell lung cancer (NSCLC) patients. The most common activating mutation present within the BRAF oncogene is associated with valine substitution for glutamate at position 600 (V600E) within the BRAF kinase. BRAF-targeted therapies are effective in patients with melanoma and NSCLC harboring BRAF V600E mutation. In both melanoma and NSCLC, dual inhibition of both BRAF and the downstream mitogen-activated protein kinase (MEK) improves response rates compared with BRAF inhibition alone. BRAF-MEK combination therapy (dabrafenib plus trametinib) demonstrated tolerability and efficacy in a recent phase II clinical trial and was approved by the European Medicines Agency and United States Food and Drug Administration for patients with stage IV NSCLC harboring BRAF V600E mutation. Here, in this review, we outline the preclinical and clinical data for BRAF and MEK inhibitor combination treatment for NSCLC patients with BRAF V600E mutation.

摘要

BRAF 癌基因中的突变存在于 2-4%的所有非小细胞肺癌 (NSCLC) 患者中。BRAF 激酶中谷氨酸被缬氨酸取代导致 BRAF 癌基因激活,这是最常见的激活突变。BRAF 靶向治疗对黑色素瘤和 NSCLC 患者中携带 BRAF V600E 突变有效。在黑色素瘤和 NSCLC 中,BRAF 和下游丝裂原活化蛋白激酶 (MEK) 的双重抑制与单独抑制 BRAF 相比,可提高反应率。在最近的一项 II 期临床试验中,BRAF-MEK 联合治疗 (dabrafenib 加 trametinib) 表现出良好的耐受性和疗效,被欧洲药品管理局和美国食品药品监督管理局批准用于治疗携带 BRAF V600E 突变的 IV 期 NSCLC 患者。在此,我们概述了 BRAF 和 MEK 抑制剂联合治疗 NSCLC 患者中 BRAF V600E 突变的临床前和临床数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/035d/5941661/26d54f870c6f/10.1177_1753466618767611-fig1.jpg

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