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一例晚期BRAF突变、微卫星稳定型结肠癌患者接受达拉非尼、曲美替尼和西妥昔单抗三线治疗后停药仍持续完全缓解:病例报告及文献综述

Ongoing complete response after treatment cessation with dabrafenib, trametinib, and cetuximab as third-line treatment in a patient with advanced BRAF mutated, microsatellite-stable colon cancer: A case report and literature review.

作者信息

Piringer Gudrun, Decker Jörn, Trommet Vera, Kühr Thomas, Heibl Sonja, Dörfler Konrad, Thaler Josef

机构信息

Department of Internal Medicine IV, Wels-Grieskirchen Medical Hospital, Wels, Austria.

Department of Hematology and Oncology, Kepler University Hospital, Linz, Austria.

出版信息

Front Oncol. 2023 May 5;13:1166545. doi: 10.3389/fonc.2023.1166545. eCollection 2023.

Abstract

Metastatic BRAF mutated colorectal cancer is associated with poor overall survival and modest effectiveness to standard therapies. Furthermore, survival is influenced by the microsatellite status. Patients with microsatellite-stable and BRAF mutated colorectal cancer have the worst prognosis under the wide range of genetic subgroups in colorectal cancer. Herein, we present a patient case of an impressive therapeutic efficacy of dabrafenib, trametinib, and cetuximab as later-line therapy in a 52-year-old woman with advanced BRAF mutated, microsatellite-stable colon cancer. This patient achieved a complete response after 1 year of triple therapy. Due to skin toxicity grade 3 and recurrent urinary tract infections due to mucosal toxicity, a therapy de-escalation to dabrafenib and trametinib was performed, and the double therapy was administered for further 41 months with ongoing complete response. For 1 year, the patient was off therapy and is still in complete remission.

摘要

转移性BRAF突变型结直肠癌与总体生存率低以及对标准疗法的疗效一般有关。此外,生存率受微卫星状态影响。在结直肠癌的广泛基因亚组中,微卫星稳定且BRAF突变的结直肠癌患者预后最差。在此,我们报告一例52岁患有晚期BRAF突变、微卫星稳定型结肠癌女性患者的病例,其接受达拉非尼、曲美替尼和西妥昔单抗作为后线治疗取得了令人瞩目的治疗效果。该患者在三联疗法治疗1年后达到完全缓解。由于3级皮肤毒性以及黏膜毒性导致的复发性尿路感染,治疗方案降级为达拉非尼和曲美替尼,双药治疗持续41个月,患者仍保持完全缓解。患者停药1年,目前仍处于完全缓解状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f6/10196488/133dc30b58f1/fonc-13-1166545-g001.jpg

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