Updated phase 2 data showed a 60% ORR and 86% CNS ORR with frontline silevertinib in non-classical EGFR-mutant NSCLC; FDA discussion supported a phase 3 trial in 2027.
|Videos|April 14, 2020
A 69-Year Old Man With Metastatic BRAF V600E-Mutated Metastatic NSCLC
A 69-Year Old Man With Metastatic BRAF V600E-Mutated Metastatic NSCLC
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Case: A 69-Year Old Man With MetastaticBRAFV600EMutated Metastatic NSCLC
Initial presentation
- A 69-year old man presented with a chronic dry cough and dyspnea on exertion
- PMH: history of hypercholesterolemia, medically treated; 20 pack-year smoking history, quit 6 years ago
- PE: decreased breath sounds on auscultation
Clinical workup
- Labs: WNL
- Chest X-ray showed a ~4-cm
- Chest/abdomen/pelvic CT showed a 3.7-cm solid pulmonary lesion in the right lobe, ipsilateral mediastinal and subcarinal lymph node involvement
- Bronchoscopy biopsy of the lung lesion and lymph nodes revealed lung adenocarcinoma
- Contrast-enhanced MRI of the head showed a small brain lesion
- Molecular and biomarker testing:
- PD-L1 TPS 20%
- EGFR-, ALK-,BRAFV600E+,ROS1-
- Stage T2aN2M1b; ECOG PS 0
Treatment and Follow-Up
- Patient started on dabrafenib 150 mg PO qDay BID + trametinib 2 mg PO qDay; achieved partial response
- Patient developed intermittent grade 1 fatigue, which was tolerable; continued treatment
- Imaging at 3, 6 and 9 months showed sustained partial response
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