Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan.
BMC Cancer. 2020 Feb 24;20(1):156. doi: 10.1186/s12885-020-6626-9.
A BRAF V600E mutation is found as driver oncogene in patients with non-small cell lung cancer. Although combined treatment with dabrafenib and trametinib is highly effective, the efficacy of reduced doses of the drugs in combination therapy has not yet been reported.
A Japanese man in his mid-sixties was diagnosed with unresectable lung adenocarcinoma and was unresponsive to cytotoxic chemotherapy and immune checkpoint inhibitors. The BRAF V600E mutation was detected by next generation sequencing, and the patient was subjected to treatment with dabrafenib and trametinib in combination. Although the treatment reduced the tumor size, he experienced myalgia and muscle weakness with elevated serum creatine kinase and was diagnosed with rhabdomyolysis induced by dabrafenib and trametinib. After the patient recovered from rhabdomyolysis, the treatment doses of dabrafenib and trametinib were reduced, which prevented further rhabdomyolysis and maintained tumor shrinkage.
The reduction of the doses of dabrafenib and trametinib was effective in the treatment of BRAF V600E-mutant NSCLC, and also prevented the incidence of rhabdomyolysis.
BRAF V600E 突变是一种驱动致癌基因，存在于非小细胞肺癌患者中。虽然达拉非尼联合曲美替尼的联合治疗非常有效，但这些药物的低剂量联合治疗的疗效尚未得到报道。
一名 60 多岁的日本男性被诊断为不能切除的肺腺癌，对细胞毒性化疗和免疫检查点抑制剂均无反应。通过下一代测序检测到 BRAF V600E 突变，该患者接受达拉非尼联合曲美替尼治疗。尽管治疗使肿瘤缩小，但他出现了肌痛和肌无力，血清肌酸激酶升高，并被诊断为达拉非尼和曲美替尼引起的横纹肌溶解症。横纹肌溶解症缓解后，降低了达拉非尼和曲美替尼的治疗剂量，既防止了进一步的横纹肌溶解症，又维持了肿瘤缩小。
降低达拉非尼和曲美替尼的剂量对治疗 BRAF V600E 突变型 NSCLC 有效，并可预防横纹肌溶解症的发生。
