A 62-Year-Old Woman With Metastatic BRAF V600E-Mutated NSCLC

Case: A 62-Year-Old Woman With MetastaticBRAF^V600E-Mutated NSCLC

Initial Presentation

• A 62-year-old woman presented with a 4-month history of chronic cough, dyspnea, loss of appetite and weight loss
• PMH/SH: 25 pack-year smoking history, quit 12 years ago
• PE: Right-sided wheezing on auscultation

Clinical Workup

• Labs: WNL
• Chest/abdomen/pelvic CT showed a 2.5-cm solid pulmonary lesion in the left inferior lobe, ipsilateral peribronchial lymph node involvement and multiple small hepatic lesions
• Bronchoscopic biopsy of the lung lesion and lymph node revealed lung adenocarcinoma
• Contrast‐enhanced MRI of the head showed no evidence of metastases
• Molecular and biomarker testing: BRAF^V600E+,EGFR-, ALK-, ROS1-,PD-L1 0%
• Stage T1cN1M1c; ECOG PS 0

Treatment and Follow-Up

• Started on dabrafenib 150 mg PO qDay BID + trametinib 2 mg PO qDay; achieved a partial response
  • Patient developed intermitted nausea and vomiting, medically controlled
• Imaging at 3,6 and 9 months showed sustained partial response