Abstract
Solid tumors harboring mutations in the Braf gene (BRAF) are currently treated by combination Braf/MEK inhibitor therapy, and there is an extensive literature on patient response rates. Alternatively, few studies have documented the clinical response of BRAF mutation-positive solid tumors to MEK inhibitor monotherapy. We report the case of a 57-year-old female diagnosed with papillary thyroid carcinoma and progressive lung metastases initially treated by total thyroidectomy and subsequent thyroid-stimulating hormone suppression therapy. Next-generation sequencing revealed that the tumor harbored a BRAFV600E mutation, and the patient was enrolled in a clinical study of the oral MEK1/2 inhibitor binimetinib. Shortly after starting treatment, the patient experienced pneumothorax due to rapid regression of lung metastases, and computed tomography after 6 months of binimetinib treatment revealed a partial sustained response. One year later, the dose was reduced because of an acneiform rash. After 5 years of binimetinib treatment, lung metastases had regrown, and treatment was switched to the oral multikinase inhibitor lenvatinib. This case demonstrates the potential of MEK inhibitor monotherapy as an alternative treatment for BRAF mutation-positive papillary thyroid carcinoma.
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The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
This content was presented in a tie-up project between the 61st Annual Meeting of the Japanese Association for Cancer Therapy and the ICCJ. This work was supported by the JSPS KAKENHI Grant 19K16829. This paper was supported by a grant from the Grant-in-Aid for Human Resource Development for Science and Technology by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) under the “Initiative for Realization of Diversity Research Environment” program for the cost of reviewing manuscripts in English.
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YA received a speaker honorarium from Chugai Pharmaceutical Co., Ltd. and Bayer Holding Ltd. He received research funding from Chugai Pharmaceutical Co., Ltd. and Geo Holding Corporation. The other authors have no conflicts of interest.
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Takano, Y., Shimokata, T., Urakawa, H. et al. Long-term response to MEK inhibitor monotherapy in a patient with papillary thyroid carcinoma harboring BRAF V600E mutation. Int Canc Conf J (2024). https://doi.org/10.1007/s13691-024-00670-w
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DOI: https://doi.org/10.1007/s13691-024-00670-w