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Tytuł pozycji:

Granulomatosis with polyangiitis in a patient treated with dabrafenib and trametinib for BRAF V600E positive lung adenocarcinoma

Tytuł:
Granulomatosis with polyangiitis in a patient treated with dabrafenib and trametinib for BRAF V600E positive lung adenocarcinoma
Autorzy:
Anastasios Dimou
Gregory Barron
Daniel T. Merrick
Jason Kolfenbach
Robert C. Doebele
Temat:
MAPK
Autoimmune side effects
MEK inhibitor
Pyrexia
P-ANCA
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Źródło:
BMC Cancer, Vol 20, Iss 1, Pp 1-5 (2020)
Wydawca:
BMC, 2020.
Rok publikacji:
2020
Kolekcja:
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Typ dokumentu:
article
Opis pliku:
electronic resource
Język:
English
ISSN:
1471-2407
Relacje:
http://link.springer.com/article/10.1186/s12885-020-6661-6; https://doaj.org/toc/1471-2407
DOI:
10.1186/s12885-020-6661-6
Dostęp URL:
https://doaj.org/article/01f0b501c2d848568da252462225f0fb  Link otwiera się w nowym oknie
Numer akcesji:
edsdoj.01f0b501c2d848568da252462225f0fb
Czasopismo naukowe
Abstract Background Dabrafenib and trametinib combination therapy is approved for the treatment of patients with BRAF V600E positive tumors including melanoma and lung cancer. The effect of BRAF and MEK inhibitors on the immune system is not fully understood although a number of case reports indicate autoimmune side effects related to the use of these drugs. Here, we discuss a case of a patient diagnosed with granulomatosis with polyangiitis (GPA) shortly after starting treatment with dabrafenib and trametinib for BRAF V600E positive metastatic lung adenocarcinoma. Case presentation A 57 years old female patient was diagnosed with recurrent lung adenocarcinoma following initial lobectomy for early stage disease. A BRAF V600E mutation was identified at the time of recurrence and she received combination dabrafenib and trametinib therapy. Shortly after commencement of treatment, she developed persistent fevers necessitating withholding both drugs. Pyrexia continued and was followed by left vision loss and acute kidney injury. Further rheumatological workup led to the unifying diagnosis of GPA. The patient was then treated with rituximab for GPA to the present date while all antineoplastic drugs were held. Lung cancer oligoprogression was addressed with radiation therapy and has not required further systemic treatment whereas GPA has been controlled to-date with rituximab. Conclusions This case report raises awareness among clinicians treating patients with lung cancer for the possibility of triggering a flare of autoimmune diseases like GPA in patients with BRAF V600E positive lung cancer receiving treatment with BRAF directed therapy.
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