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Dabrafenib and trametinib therapy in an elderly patient with non-small cell lung cancer harboring the BRAF V600E mutation.

Abstract
Dabrafenib and trametinib therapy for BRAF V600E-mutant non-small cell lung cancer (NSCLC) has demonstrated strong antitumor effects in clinical trials and has been approved for use in clinical practice. However, the efficacy and safety of this combination therapy in elderly patients remain unclear. An 86-year-old male patient, who had been diagnosed with lung adenocarcinoma with the BRAF V600E mutation, received dabrafenib and trametinib combination chemotherapy. The tumor shrunk rapidly; however, therapy was discontinued after 40 days because adverse events (hypoalbuminemia, peripheral edema, and pneumonia) developed. Although this targeted combination therapy seemed to cause relatively severe adverse events compared with single-agent targeted therapy in this "oldest old" elderly patient, the marked tumor shrinkage prolonged the patient's life and helped him to maintain a good general condition. Active targeted therapy may therefore be considered with appropriate drug dose reduction instead of conservative treatment, even if a patient is extremely old.
AuthorsYosuke Dotsu, Minoru Fukuda, Noritaka Honda, Hiroshi Gyotoku, Yoshihisa Kohno, Takayuki Suyama, Yasuhiro Umeyama, Hirokazu Taniguchi, Shinnosuke Takemoto, Hiroyuki Yamaguchi, Taiga Miyazaki, Noriho Sakamoto, Yasushi Obase, Hiroaki Ikeda, Kazuto Ashizawa, Hiroshi Mukae
JournalThoracic cancer (Thorac Cancer) Vol. 12 Issue 2 Pg. 272-276 (01 2021) ISSN: 1759-7714 [Electronic] Singapore
PMID33215864 (Publication Type: Case Reports, Journal Article)
Copyright© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
Chemical References
  • Imidazoles
  • Oximes
  • Pyridones
  • Pyrimidinones
  • trametinib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • dabrafenib
Topics
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (pharmacology, therapeutic use)
  • Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
  • Humans
  • Imidazoles (pharmacology, therapeutic use)
  • Lung Neoplasms (drug therapy, pathology)
  • Male
  • Mutation
  • Oximes (pharmacology, therapeutic use)
  • Proto-Oncogene Proteins B-raf (metabolism)
  • Pyridones (pharmacology, therapeutic use)
  • Pyrimidinones (pharmacology, therapeutic use)

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