【佳學(xué)基因靶向藥物基因檢測】攜帶 BRAF V600E 突變的非小細(xì)胞肺癌腹膜癌患者對 Dabrafenib 加曲美替尼的有希望的反應(yīng)

變異引發(fā)的瘋基因能醫(yī)治嗎介紹

綜述的藥物化治療及藥物選擇《腫瘤藥物的有效及有效性》《Onco Targets Ther》在?2022 Nov 11;15:1369-1374.發(fā)表了一篇題目為《Case Reports》腫瘤靶向藥物治療基因檢測臨床研究文章。該研究由Yuri Yagami,?Yoshiro Nakahara,?Hideaki Manabe,?Hiroki Yamamoto,?Sakiko Otani,?Takashi Sato,?Satoshi Igawa,?Masaru Kubota,?Jiichiro Sasaki,?Katsuhiko Naoki等完成。促進(jìn)了腫瘤的正確治療與個(gè)性化用藥的發(fā)展，進(jìn)一步強(qiáng)調(diào)了基因信息檢測與分析的重要性。

腫瘤基因檢測及靶向藥物治療研究關(guān)鍵詞：

BRAF V600E突變,達(dá)拉非尼,肺癌,腹膜癌病,曲美替尼。

腫瘤治療檢測基因臨床應(yīng)用結(jié)果

靶向藥物研究立項(xiàng)的依據(jù)：肺癌患者腹膜轉(zhuǎn)移的預(yù)后較差。然而，一些攜帶特定基因改變的肺癌腹膜轉(zhuǎn)移病例對分子靶向藥物有反應(yīng)。 B-Raf 原癌基因 (BRAF) 突變發(fā)生在約 2-4% 的非小細(xì)胞肺癌中，其中約一半具有 BRAF V600E 突變。達(dá)拉非尼聯(lián)合抑制 BRAF 和曲美替尼聯(lián)合抑制下游絲裂原活化蛋白激酶在 BRAF V600E 突變的 NSCLC 患者中顯示出療效。在此，我們報(bào)告了一名患有 BRAF V600E 突變的肺癌腹膜癌轉(zhuǎn)移患者對達(dá)拉非尼加曲美替尼有反應(yīng)。病例介紹：一名 67 歲的日本男性從不吸煙者被診斷患有 IA3 期肺腺癌。他接受了胸腔鏡左下肺葉切除術(shù)，但在手術(shù)后 33 個(gè)月出現(xiàn)癌癥反復(fù)并伴有腹膜癌轉(zhuǎn)移。切除標(biāo)本的 Oncomine Dx 目標(biāo)測試對 BRAF V600E 突變呈陽性。他開始服用 dabrafenib 150 mg 每天兩次和曲美替尼 2 mg 每天一次。他對 dabrafenib/trametinib 治療有良好的臨床反應(yīng)，腹脹消退。他繼續(xù) dabrafenib/trametinib 治療 7 個(gè)月沒有疾病進(jìn)展，沒有嚴(yán)重的不良反應(yīng)。藥物指導(dǎo)及病因判斷的依據(jù)：該病例強(qiáng)調(diào)了評估肺癌腹膜轉(zhuǎn)移患者的基因改變并用適當(dāng)?shù)姆肿影邢蛩幬镏委煹闹匾?。關(guān)鍵詞：BRAF V600E突變;達(dá)拉非尼；肺癌；腹膜癌??；曲美替尼。

腫瘤發(fā)生與革命國際數(shù)據(jù)庫描述：

Background:?The prognosis of peritoneal carcinomatosis in patients with lung cancer is poor. However, some cases of peritoneal carcinomatosis from lung cancer harboring specific gene alterations have responded to molecular targeted drugs. B-Raf proto-oncogene (BRAF) mutations occur in about 2-4% of NSCLCs, with about half of these cases having the BRAF V600E mutation. Concomitant inhibition of BRAF with dabrafenib and inhibition of the downstream mitogen-activated protein kinase with trametinib showed efficacy in NSCLC patients with the BRAF V600E mutation. Herein, we report a patient with peritoneal carcinomatosis from lung cancer with the BRAF V600E mutation who responded to dabrafenib plus trametinib.Case presentation:?A 67-year-old Japanese male never-smoker was diagnosed with stage IA3 lung adenocarcinoma. He underwent thoracoscopic left lower lobectomy but developed recurrence of the cancer with peritoneal carcinomatosis 33 months after the operation. An Oncomine Dx target test of the resected specimen was positive for the?BRAF?V600E mutation. He was started on dabrafenib 150 mg twice per day and trametinib 2 mg once per day. He had a good clinical response to dabrafenib/trametinib therapy with resolution of abdominal distention. He continued dabrafenib/trametinib treatment without disease progression for 7 months, with no severe adverse effects.Conclusion:?This case highlights the importance of assessing genetic alterations in lung cancer patients with peritoneal carcinomatosis and treating them with appropriate molecular targeted drugs.Keywords:?BRAF V600E mutation; dabrafenib; lung cancer; peritoneal carcinomatosis; trametinib.