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达拉非尼和曲美替尼治疗复发 BRAF V600E 突变型多发性骨髓瘤的部分缓解及可能的耐药机制。

Partial response to dabrafenib and trametinib in relapsed BRAF V600E-Mutated multiple myeloma and possible mechanisms of resistance.

机构信息

Medical Oncology, Zuger Kantonsspital, Baar, Switzerland

Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland.

出版信息

BMJ Case Rep. 2022 Apr 8;15(4):e246264. doi: 10.1136/bcr-2021-246264.

DOI:10.1136/bcr-2021-246264
PMID:35396243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8996037/
Abstract

BRAF V600E mutations are detected in 3%-10% of patients with multiple myeloma (MM) and are associated with more aggressive disease, higher frequency of extramedullary growth and shorter survival. Monotherapy with the BRAF inhibitor vemurafenib has been disappointing in MM. In patients with BRAF-mutated melanoma, MEK and BRAF inhibition has been a successful approach. Here we describe a very good partial response and possible mechanisms of resistance to a combination of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib in a patient with BRAF V600E-mutant refractory MM.

摘要

BRAF V600E 突变在 3%-10%的多发性骨髓瘤（MM）患者中被检测到，与更具侵袭性的疾病、更高的髓外生长频率和更短的生存期相关。BRAF 抑制剂 vemurafenib 在 MM 中的单药治疗效果令人失望。在 BRAF 突变型黑色素瘤患者中，MEK 和 BRAF 抑制已成为一种成功的治疗方法。在这里，我们描述了一名 BRAF V600E 突变型难治性 MM 患者对 BRAF 抑制剂 dabrafenib 和 MEK 抑制剂 trametinib 联合治疗的非常好的部分缓解和可能的耐药机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/6c55dd9c6652/bcr-2021-246264f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/014583e7b9a9/bcr-2021-246264f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/241524b14711/bcr-2021-246264f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/6c55dd9c6652/bcr-2021-246264f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/014583e7b9a9/bcr-2021-246264f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/241524b14711/bcr-2021-246264f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39da/8996037/6c55dd9c6652/bcr-2021-246264f03.jpg

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本文引用的文献

1
Combination of Dabrafenib and Trametinib for the Treatment of Relapsed and Refractory Multiple Myeloma Harboring BRAF V600E Mutation.达拉非尼与曲美替尼联合治疗携带BRAF V600E突变的复发难治性多发性骨髓瘤
Case Rep Hematol. 2020 Oct 15;2020:8894031. doi: 10.1155/2020/8894031. eCollection 2020.
2
Vemurafenib in Patients With Relapsed Refractory Multiple Myeloma Harboring Mutations: A Cohort of the Histology-Independent VE-BASKET Study.维莫非尼治疗携带 突变的复发难治性多发性骨髓瘤患者：组织学独立的 VE-BASKET 研究队列
JCO Precis Oncol. 2018 Aug 31;2. doi: 10.1200/PO.18.00070. eCollection 2018.
3
Rapid BRAF mutation tests in patients with advanced melanoma: comparison of immunohistochemistry, Droplet Digital PCR, and the Idylla Mutation Platform.
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J Craniomaxillofac Surg. 2023 Oct;51(10):591-596. doi: 10.1016/j.jcms.2023.10.003. Epub 2023 Oct 11.
4
Plasma cell myeloma with RAS/BRAF mutations is frequently associated with a complex karyotype, advanced stage disease, and poorer prognosis.伴 RAS/BRAF 突变的浆细胞骨髓瘤常与复杂核型、晚期疾病和预后不良相关。
Cancer Med. 2023 Jul;12(13):14293-14304. doi: 10.1002/cam4.6103. Epub 2023 May 22.
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Precision Medicine Approach Based on Molecular Alterations for Patients with Relapsed or Refractory Multiple Myeloma: Results from the MM-EP1 Study.基于分子改变的复发或难治性多发性骨髓瘤患者精准医学方法：MM-EP1研究结果
Cancers (Basel). 2023 Feb 28;15(5):1508. doi: 10.3390/cancers15051508.
晚期黑色素瘤患者的快速BRAF突变检测：免疫组织化学、液滴数字PCR和Idylla突变平台的比较
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Cancer Cell. 2014 Jan 13;25(1):91-101. doi: 10.1016/j.ccr.2013.12.015.
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Cancer Discov. 2013 Aug;3(8):862-9. doi: 10.1158/2159-8290.CD-13-0014. Epub 2013 Apr 23.
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