Response to MAPK pathway inhibitors in BRAF V600M-mutated metastatic melanoma

J Clin Pharm Ther. 2015 Feb;40(1):121-3. doi: 10.1111/jcpt.12229. Epub 2014 Nov 10.

Abstract

What is known and objective: The management of metastatic melanoma has changed significantly in the past decade with the development of immunotherapies and targeted molecular therapies. Trials of targeted therapies have focused mainly on patients with the most common BRAF V600 mutations, namely V600E/K substitutions, with very little information available on the benefit of targeted therapies on less commonly occurring mutations such as V600R/D and M.

Case summary: We present a 54-year-old man with metastatic melanoma harbouring a rare BRAF V600M mutation, who experienced clinical and radiological response to combined therapy with the BRAF inhibitor dabrafenib and MEK inhibitor trametinib.

What is new and conclusion: As our understanding of these therapies evolves and an increasing number of patients have mutational testing performed, there is a clear imperative--as highlighted by this case--to test for rarer mutations and facilitate their inclusion both in everyday practice and in future clinical trials.

Keywords: BRAF mutation; V600M; melanoma; targeted therapy.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Neoplasms / drug therapy*
  • Abdominal Neoplasms / secondary
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary
  • Humans
  • Imidazoles / therapeutic use
  • Intestinal Neoplasms / drug therapy*
  • Intestinal Neoplasms / secondary
  • Lymphatic Metastasis
  • Male
  • Melanoma / drug therapy*
  • Melanoma / genetics
  • Melanoma / pathology
  • Melanoma / secondary
  • Middle Aged
  • Molecular Targeted Therapy / methods
  • Mutation / genetics
  • Oximes / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use*
  • Proto-Oncogene Proteins B-raf / genetics*
  • Pyridones / therapeutic use
  • Pyrimidinones / therapeutic use
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / genetics
  • Skin Neoplasms / pathology
  • Treatment Outcome

Substances

  • Imidazoles
  • Oximes
  • Protein Kinase Inhibitors
  • Pyridones
  • Pyrimidinones
  • trametinib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • dabrafenib