Effects of chemotherapy combined with immunotherapy for non-small cell lung cancer with -mutations: a retrospective study.

OBJECTIVES

To characterize the clinical features of non-small cell lung cancer (NSCLC) harboring BRAF mutations and to evaluate the effects of first-line chemotherapy combined with immunotherapy versus targeted therapy.

METHODS

We retrospectively reviewed patients with BRAF-mutated NSCLC diagnosed between January 2017 and June 2023 at the Affiliated Cancer Hospital of Zhengzhou University. A total of 120 patients were included, with an overall BRAF mutation frequency of 0.9%. Among the mutations detected, the Val600Glu (V600E) substitution constituted 54.2% of cases. Clinical characteristics were compared between V600E and non-V600E subgroups, and treatment efficacies were analyzed.

RESULTS

Ninety-five patients received first-line treatment. The overall median progression-free survival (mPFS) was 8.77 months, and the median overall survival (mOS) was 13.30 months. First-line chemotherapy combined with immunotherapy resulted in longer mPFS (17.17 vs. 9.03 months, P = 0.573) and mOS (17.50 vs. 16.07 months, P = 0.376) compared with targeted therapy using BRAF and MEK inhibitors. In addition, patients with V600E mutations exhibited a trend toward longer mPFS compared to those with non-V600E mutations (9.73 vs. 6.77 months, P = 0.244).

CONCLUSIONS

Chemotherapy combined with immunotherapy may represent a promising first-line treatment strategy for NSCLC patients with BRAF mutations. Although the number of patients receiving subsequent lines of treatment was limited and their prognosis poor, a regimen of BRAF and MEK inhibitors appeared to offer therapeutic advantages in this setting.