Treatment of BRAF Mutated Non-Small Cell Lung Cancer

July 21, 2017

Treatment of BRAF Mutated Non-Small Cell Lung Cancer

67-year-old female, former smoker (30 pack-years, quit 10 years ago) presented to her pulmonologist with increased cough, dyspnea and hemoptysis.
Past medical history of mild COPD.
Patient swims three times a week and is continuing normal activities.
ECOG PS was assessed as 1.
CT scan of chest and abdomen show a lower right lobe lung nodule with several small liver lesions.
PET/CT scan indicated lung cancer with liver metastases.
Core needle biopsy was performed in the liver. Pathology report showed adenocarcinoma consistent with non-small cell lung cancer (NSCLC).
Mutation testing showed aBRAF V600Emutation.
PD-L1 status was negative.
Patient was started on pemetrexed and carboplatin.
After 3 of 6 planned cycles patient showed worsening signs of dyspnea with a weight loss of 10%.
Repeat CT scan showed progression of primary lesion.
Patient was started on dabrafenib + trametinib.