What is the BRAF mutation in lung cancer?
The mutation of the BRAF gene occurs in les s than 2% of patients diagnosed with non-small cell lung cancer. It generally does not occur together with EGFR mutations or ALK and ROS1 rearrangements. It is most frequently seen in patients diagnosed with an adenocarcinoma histology.
Among the different mutations that can be observed in the BRAF gene, the one that confers therapeutic relapse is V600E, which is frequently observed in patients diagnosed with melanoma. Preclinical studies have demonstrated the effect of dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor) on non-small cell lung cancer cell lines carrying BRAF V600E mutation.
The combination of dabrafenib and trametinib represents already the standard therapy of melanoma patients carrying the V600E mutation of the BRAF gene.
Treatment of patients with BRAF gene mutation
A phase II study assessed the effectiveness of the dabrafenib and trametinib combination in 59 patients diagnosed with non-small cell lung cancer carrying the BRAF V600E mutation who underwent at least one line of chemotherapy. Dabrafenib and trametinib are two drugs that are administered orally every day.
The study revealed an objective response rate of 63% with a progression-free-survival of about 10 months.
The combination of dabrafenib and trametinib is not yet registered in Italy and thus is not covered by the Italian National Health Service (SSN). However, based on the positive results of this phase II study, it is possible to request this treatment combination from the Italian Drug Regulatory Agency (AIFA) following failure of standard first-line therapy.
For this reason, it is important to search for BRAF mutations among the other molecular markers at the time of diagnosis.
To find out about the side effects of dabrafenib and trametinib, go to the side effects section.