Department of Medical Oncology, University Clinic Golnik, 4204 Golnik, Slovenia.
Medical Faculty Ljubljana, University of Ljubljana, 1000 Ljubljana, Slovenia.
Int J Mol Sci. 2023 Aug 16;24(16):12840. doi: 10.3390/ijms241612840.
BRAF and cMET exon 14 skipping are rare mutations of NSCLC. The treatment sequence in these cases for the first and second line is not clear. An international registry was created for patients with advanced NSCLC harboring BRAF or cMET exon 14 skipping mutations, diagnosed from January 2017 to June 2022. Clinicopathological and molecular data and treatment patterns were recorded. Data on 58 patients, from eight centers across five countries, were included in the final analysis. We found that 40 patients had the cMET exon 14 skipping mutation and 18 had the BRAF V600E mutation. In total, 53 and 28 patients received first- and second-line treatments, respectively, among which 52.8% received targeted therapy (TT) in the first line and 53.5% in the second line. The overall response rate (ORR) and disease control rate (DCR) for first-line treatment with TT vs. other treatment such as immune checkpoint inhibitors ± chemotherapy (IO ± CT) were 55.6% vs. 21.7% ( = 0.0084) and 66.7% vs. 39.1% ( = 0.04), respectively. The type of treatment in first-line TT vs. other affected time to treatment discontinuation (TTD) was 11.6 m vs. 4.6 m (= 0.006). The overall survival for the whole group was 15.4 m and was not statistically affected by the type of treatment (19.2 m vs. 13.5 m; = 0.83).
BRAF 和 cMET 外显子 14 跳跃突变是 NSCLC 的罕见突变。这些情况下的一线和二线治疗顺序尚不清楚。为了评估 BRAF 或 cMET 外显子 14 跳跃突变的晚期 NSCLC 患者的治疗方案,我们建立了一个国际登记处,登记时间为 2017 年 1 月至 2022 年 6 月。记录了临床病理和分子数据以及治疗模式。最终分析纳入了来自五个国家的 8 个中心的 58 例患者的数据。我们发现 40 例患者存在 cMET 外显子 14 跳跃突变,18 例患者存在 BRAF V600E 突变。共 53 例和 28 例患者分别接受了一线和二线治疗,其中 52.8%的患者在一线接受了靶向治疗(TT),53.5%的患者在二线接受了 TT。TT 与免疫检查点抑制剂联合化疗(IO ± CT)等其他治疗方案一线治疗的总缓解率(ORR)和疾病控制率(DCR)分别为 55.6%和 21.7%( = 0.0084)和 66.7%和 39.1%( = 0.04)。一线 TT 与其他治疗方案的治疗类型影响治疗终止时间(TTD),分别为 11.6 个月和 4.6 个月( = 0.006)。全组的总生存时间为 15.4 个月,与治疗类型无关(19.2 个月比 13.5 个月; = 0.83)。