Bao Loc Carlo, Padovan Alessia, Boscolo Bragadin Andrea, Calvetti Lorenzo, Guarneri Valentina, Bonanno Laura, Indraccolo Stefano
Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Basic and Translational Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
Front Oncol. 2024 Mar 11;14:1363069. doi: 10.3389/fonc.2024.1363069. eCollection 2024.
Epidermal Growth Factor Receptor (EGFR) and B-Raf (BRAF) mutations are two of the most important drivers identified in non-small-cell lung cancer (NSCLC). This report highlights two cases of patients diagnosed with metastatic NSCLC bearing concurrent EGFR and BRAF mutations at baseline and treated with osimertinib as first-line treatment. Molecular profiling was conducted in the tissue and plasma at the time of initial diagnosis, and subsequent repeated liquid biopsy examinations were planned after 10 days, 28 days, and at the time of radiological progression in the frame of the prospective translational study REM. These cases suggest that osimertinib may maintain its therapeutic effectiveness even in patients presenting with a baseline BRAF co-mutation. Notably, radiological responses align with liquid biopsy observations: in both instances, follow-up liquid biopsies indicate the clearance of EGFR-mutated circulating tumor DNA (ctDNA).
表皮生长因子受体（EGFR）和B-Raf（BRAF）突变是在非小细胞肺癌（NSCLC）中发现的两个最重要的驱动因素。本报告重点介绍了两例被诊断为转移性非小细胞肺癌的患者，他们在基线时同时存在EGFR和BRAF突变，并接受奥希替尼作为一线治疗。在初始诊断时对组织和血浆进行了分子分析，并在前瞻性转化研究REM的框架内，计划在10天、28天以及影像学进展时进行后续重复液体活检检查。这些病例表明，即使在基线存在BRAF共突变的患者中，奥希替尼也可能保持其治疗效果。值得注意的是，影像学反应与液体活检观察结果一致：在这两个病例中，后续液体活检均显示EGFR突变的循环肿瘤DNA（ctDNA）清除。
