March 27, 2020


Case: A 62-Year-Old Woman With MetastaticBRAFV600E-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: BRAFV600E+,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