Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Japan
Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Japan.
BMJ Case Rep. 2024 May 8;17(5):e255958. doi: 10.1136/bcr-2023-255958.
The combination therapy of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) and mitogen-activated protein kinase kinase (MEK) inhibitors is approved for treating patients with BRAF V600E-positive tumours, including melanoma and lung cancer. Several case reports indicated autoimmune side effects associated with the use of BRAF and MEK inhibitors. Still, the effects of these drugs on the immune system were not fully elucidated. Here, we report a patient with large-vessel vasculitis diagnosed after initiation of treatment with dabrafenib and trametinib for BRAF V600E-positive metastatic lung adenocarcinoma. She was a never-smoker woman in her early 70s who presented with a chronic cough and was diagnosed with BRAF V600E-positive metastatic lung adenocarcinoma by transbronchial lung biopsy. She was successfully treated with prednisolone and methotrexate while BRAF and MEK inhibitors were continued. We should be careful about autoimmune diseases using BRAF and MEK inhibitors.
BRAF 和 MEK 抑制剂的联合治疗已被批准用于治疗 BRAF V600E 阳性肿瘤的患者，包括黑色素瘤和肺癌。一些病例报告表明，BRAF 和 MEK 抑制剂的使用与自身免疫副作用有关。然而，这些药物对免疫系统的影响尚未完全阐明。在这里，我们报告了一例在开始使用 dabrafenib 和 trametinib 治疗 BRAF V600E 阳性转移性肺腺癌后被诊断为大血管血管炎的患者。她是一位 70 岁出头的从不吸烟的女性，因慢性咳嗽就诊，经支气管肺活检诊断为 BRAF V600E 阳性转移性肺腺癌。她在继续使用 BRAF 和 MEK 抑制剂的同时，接受了泼尼松龙和甲氨蝶呤治疗，取得了成功。我们应该注意使用 BRAF 和 MEK 抑制剂时可能出现的自身免疫性疾病。
