Chmielewska Izabela, Krawczyk Paweł, Wójcik-Superczyńska Magdalena, Grenda Anna, Gil Michał, Stencel Katarzyna, Kieszko Robert, Jankowski Tomasz, Milanowski Janusz
Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.
Department of Clinical Oncology with the Sub-Division of Daily Chemotherapy, The Greater Poland Centre for Pulmonology and Thoracic Surgery named after Eugenia and Janusz Zeyland, Poznań, Poland.
Transl Lung Cancer Res. 2024 Oct 31;13(10):2491-2499. doi: 10.21037/tlcr-24-253. Epub 2024 Oct 25.
The use of immunotherapy in treatment of non-small cell lung cancer (NSCLC) patients with the gene mutations is an area of active research and is an item of clinical trials. While mutations are relatively infrequent in NSCLC patients, comprising approximately 1-3% of cases, the V600E substitution stands out as the most prevalent subtype of mutations. The presence of this mutation in cancer cells qualifies the patients for first-line therapy with BRAF and MEK inhibitors. This study aims to evaluate the efficacy of immunotherapy in NSCLC patients with BRAF mutations. We presented a series of seven NSCLC cases with mutations, four of whom received immunotherapy or chemoimmunotherapy.
We observed benefit from immunotherapy in all patients, but its duration depended on comorbidities and the presence of brain metastases. Utilization of the next generation sequencing (NGS) technique causes high detection frequency of BRAF mutations (4.7% of patients), although mutations other than V600E may predominate (4 out of 7 patients).
In patients receiving immune checkpoint inhibitors (ICIs)-based therapy, the median progression-free survival (PFS) was 17 months from the start of immunotherapy, the overall objective response rate (ORR) was 50%, and disease control was achieved in all patients.
Immunotherapy can benefit NSCLC patients with BRAF mutations, though its efficacy is affected by comorbidities and brain metastases. The use of NGS enhances mutation detection, highlighting the need for personalized treatment approaches in NSCLC management. The varying responses to treatments among the patients emphasize the complexity of NSCLC management and the necessity for a personalized approach.
在治疗具有 基因突变的非小细胞肺癌（NSCLC）患者中使用免疫疗法是一个活跃的研究领域，也是临床试验的一个项目。虽然 基因突变在NSCLC患者中相对不常见，约占病例的1 - 3%，但V600E替代是 基因突变中最常见的亚型。癌细胞中这种突变的存在使患者有资格接受BRAF和MEK抑制剂的一线治疗。本研究旨在评估免疫疗法在具有BRAF突变的NSCLC患者中的疗效。我们报告了一系列7例具有 基因突变的NSCLC病例，其中4例接受了免疫疗法或化疗免疫疗法。
我们观察到所有患者都从免疫疗法中获益，但其持续时间取决于合并症和脑转移的存在。利用下一代测序（NGS）技术导致BRAF突变的检测频率很高（占患者的4.7%），尽管除V600E之外的突变可能占主导（7例患者中有4例）。
在接受基于免疫检查点抑制剂（ICI）治疗的患者中，从免疫疗法开始的无进展生存期（PFS）中位数为17个月，总体客观缓解率（ORR）为50%，所有患者均实现了疾病控制。
免疫疗法可使具有BRAF突变的NSCLC患者获益，但其疗效受合并症和脑转移的影响。NGS的使用提高了突变检测率，凸显了在NSCLC管理中采用个性化治疗方法的必要性。患者对治疗的不同反应强调了NSCLC管理的复杂性以及个性化方法的必要性。
