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使用达拉非尼和曲美替尼治疗晚期甲状腺癌继发吉兰-巴雷综合征

Guillain-Barre Syndrome Secondary to the Use of Dabrafenib and Trametinib for the Treatment of Advanced Thyroid Carcinoma.

作者信息

Batra Jaskaran, Ankireddypalli Anvitha, Kanugula Ashok K, Gorle Swathi, Kaur Jasleen

机构信息

Department of Internal Medicine, University of Pittsburgh Medical Center (UMPC) McKeesport, McKeesport, USA.

Department of Endocrinology, University of Minnesota School of Medicine, Minneapolis, USA.

出版信息

Cureus. 2023 Feb 16;15(2):e35069. doi: 10.7759/cureus.35069. eCollection 2023 Feb.

Abstract

BRAF V600E mutation in thyroid malignancies is associated with an aggressive phenotype with more rapid tumor growth and higher mortality. V600E is a driver mutation in the BRAF proto-oncogene, where valine (V) is substituted by glutamic acid (E) at amino acid 600. New chemotherapeutic agents targeting the mitogen-activated protein kinase (MAPK) pathway, including direct BRAF inhibitors, have become available and are increasingly used in various advanced thyroid malignancies. These agents are associated with various rare neurological adverse effects. We present a case of Guillain-Barre syndrome (GBS) secondary to dabrafenib and trametinib therapy for the management of anaplastic thyroid carcinoma. A few cases of GBS have been reported previously with the use of these agents in the treatment of melanoma. To our knowledge, this is the first case of GBS with the use of dabrafenib and trametinib for advanced thyroid malignancy. The knowledge of this rare, potentially life-threatening condition is important for clinicians to know, given the increased use of these agents in managing advanced thyroid malignancies.

摘要

甲状腺恶性肿瘤中的BRAF V600E突变与侵袭性表型相关,肿瘤生长更快,死亡率更高。V600E是BRAF原癌基因中的驱动突变,其中缬氨酸(V)在第600位氨基酸处被谷氨酸(E)取代。靶向丝裂原活化蛋白激酶(MAPK)途径的新型化疗药物,包括直接BRAF抑制剂,已可供使用,并越来越多地用于各种晚期甲状腺恶性肿瘤。这些药物与各种罕见的神经不良反应相关。我们报告一例因使用达拉非尼和曲美替尼治疗间变性甲状腺癌继发吉兰-巴雷综合征(GBS)的病例。此前已有少数使用这些药物治疗黑色素瘤导致GBS的病例报道。据我们所知,这是首例使用达拉非尼和曲美替尼治疗晚期甲状腺恶性肿瘤导致GBS的病例。鉴于这些药物在治疗晚期甲状腺恶性肿瘤中的使用增加,了解这种罕见的、可能危及生命的疾病对临床医生来说很重要。

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