Wang Ziyao, He Du, Chen Chen, Liu Xubao, Ke Nengwen
Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2022 Jan 25;11:801320. doi: 10.3389/fonc.2021.801320. eCollection 2021.
Vemurafenib and trametinib have a lot of successful experiences in the treatment of unresectable or metastatic melanoma with BRAF V600E mutation. However, they have not been reported in the treatment of advanced pancreatic ductal adenocarcinoma (PDAC). We report here a 66-year-old male who was diagnosed as PDAC with multiple metastases of the abdominal cavity and liver according to pathological examination. After three cycles of gemcitabine plus nab-paclitaxel (GA) regimen chemotherapy, the liver metastasis of the patient progressed, and the patient could not continue to receive chemotherapy because of poor physical condition. BRAF V600E mutation was found by genetic detection in this patient, so targeted therapy with vemurafenib combined with trametinib was performed and the follow-up period was up to 24 months. To the best of our knowledge, this is a rare report that patients with stage IV PDAC with BRAF V600E mutation can receive significantly survival benefits from targeted therapy with vemurafenib combined with trametinib. This report provides experience for the use of these two drugs in patients with advanced PDAC.
维莫非尼和曲美替尼在治疗具有BRAF V600E突变的不可切除或转移性黑色素瘤方面有许多成功经验。然而，它们在晚期胰腺导管腺癌（PDAC）治疗中的应用尚未见报道。我们在此报告一名66岁男性，经病理检查确诊为PDAC伴腹腔和肝脏多发转移。在接受三个周期的吉西他滨联合白蛋白结合型紫杉醇（GA）方案化疗后，患者肝脏转移进展，且因身体状况不佳无法继续接受化疗。通过基因检测发现该患者存在BRAF V600E突变，遂对其进行维莫非尼联合曲美替尼的靶向治疗，随访期长达24个月。据我们所知，这是一份罕见的报告，即具有BRAF V600E突变的IV期PDAC患者可从维莫非尼联合曲美替尼的靶向治疗中显著获益。本报告为这两种药物在晚期PDAC患者中的应用提供了经验。
