BRAF V600E-mutated lung adenocarcinoma with metastases to the brain responding to treatment with vemurafenib

Lung Cancer. 2014 Aug;85(2):326-30. doi: 10.1016/j.lungcan.2014.05.009. Epub 2014 May 21.

Abstract

Somatic BRAF mutations have been reported in 1-4% of non-small cell lung cancer (NSCLC), primarily in adenocarcinomas with the BRAF (V600E) mutation in about 50% of the cases. The role of BRAF mutation in NSCLC and the treatment for tumors with such mutations is still evolving. Our patient had metastatic NSCLC with metastases to her brain. Due to the BRAF (V600E) mutation in her tumor and her poor functional status, we offered her off-label treatment with vemurafenib, a BRAF inhibitor approved for use in metastatic melanoma. Our patient's visceral disease improved supporting vemurafenib's efficacy in the treatment of metastatic BRAF-mutated NSCLC. The regression of intracranial disease indicated vemurafenib was able to cross the blood-brain barrier and was efficacious in treating brain metastases in this patient with lung cancer.

Keywords: BRAF mutation; Brain metastasis; Lung adenocarcinoma; Non-small cell lung cancer; Targeted therapy; Vemurafenib.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / genetics*
  • Adenocarcinoma / pathology*
  • Adenocarcinoma of Lung
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary*
  • Female
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Indoles / therapeutic use*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / genetics*
  • Lung Neoplasms / pathology*
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging
  • Middle Aged
  • Mutation*
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins B-raf / genetics*
  • Sulfonamides / therapeutic use*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vemurafenib

Substances

  • Antineoplastic Agents
  • Indoles
  • Protein Kinase Inhibitors
  • Sulfonamides
  • Vemurafenib
  • Proto-Oncogene Proteins B-raf