Anai Satoshi, Isa Kohei, Chibana Rin, Ueno Shiho, Sato Yoko
Division of Respiratory Medicine, Yuuai Medical Center, Okinawa, JPN.
Cureus. 2024 Dec 6;16(12):e75217. doi: 10.7759/cureus.75217. eCollection 2024 Dec.
We report the case of a 73-year-old man with progressive dyspnea and acute respiratory failure. Imaging revealed extensive infiltrative shadows in the right lung. A bronchoscopic biopsy confirmed primary lung adenocarcinoma harboring the BRAF V600E mutation. The patient's performance score was three, requiring four liter/minute of supplemental oxygen to maintain an oxygen saturation of 90%. After a thorough discussion and informed consent, treatment with dabrafenib and trametinib was initiated despite the risks associated with his condition. Following the initiation of therapy, the patient exhibited significant clinical and radiological improvements. He continues to receive the combination therapy without significant adverse events, and his disease remains stable. We report this as the first case that demonstrates dabrafenib and trametinib can be effective and well-tolerated in patients with BRAF V600E mutated non-small cell lung cancer (NSCLC), even in those with poor performance status and acute respiratory failure. This result provides early evidence supporting the cautious use of molecular-targeted therapies in such patients.
我们报告了一例73岁男性患者,其患有进行性呼吸困难和急性呼吸衰竭。影像学检查显示右肺有广泛的浸润性阴影。支气管镜活检证实为原发性肺腺癌,伴有BRAF V600E突变。患者的体能状态评分为3分,需要每分钟4升的补充氧气以维持90%的血氧饱和度。经过充分讨论并获得知情同意后,尽管存在与他病情相关的风险,仍开始使用达拉非尼和曲美替尼进行治疗。开始治疗后,患者在临床和影像学上均有显著改善。他继续接受联合治疗,未出现明显不良事件,病情保持稳定。我们将此报告为第一例表明达拉非尼和曲美替尼对BRAF V600E突变的非小细胞肺癌(NSCLC)患者有效且耐受性良好的病例,即使是那些体能状态较差和患有急性呼吸衰竭的患者。这一结果为在此类患者中谨慎使用分子靶向治疗提供了早期证据。