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Vemurafenib in combination with cobimetinib in relapsed and refractory extramedullary multiple myeloma harboring the
Ulrich J M Mey1, Christoph Renner2, Roger von Moos1
1Medical Oncology and Hematology, Kantonsspital Graubuenden, Chur, Switzerland.
Abstract:
BRAF mutations are present in a variety of cancers and cause constitutive activation of the Ras-Raf-MEK-ERK signaling pathway. In cutaneous malignant melanoma, combined treatment with BRAF and MEK inhibitors is associated with high response rates and has been shown to improve progression free as well as overall survival compared to BRAF inhibition alone. In multiple myeloma, BRAF mutations are detectable only in a minority of patients. Only few data are available regarding the clinical activity of BRAF inhibitors in BRAF-positive multiple myeloma patients, including some anecdotal reports on remarkable responses in individuals being resistant to all other available anti-myeloma treatment approaches. We here present the first report on the combination of vemurafenib and cobimetinib in a young patient with highly resistant and rapidly progressing multiple myeloma harboring the BRAF V600E mutation who achieved a rapid and sustained response to this combination therapy.
Insights
BRAF inhibitors, vemurafenib and cobimetinib, show promise for treating advanced multiple myeloma with BRAF V600E mutations. This combination therapy offers a new treatment avenue for patients resistant to other therapies.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- BRAF mutations activate the Ras-Raf-MEK-ERK pathway, common in various cancers.
- Combined BRAF and MEK inhibitors improve outcomes in melanoma.
- BRAF mutations are infrequent in multiple myeloma, with limited data on inhibitor efficacy.
Observation:
- A young patient with rapidly progressing, treatment-resistant multiple myeloma harbored a BRAF V600E mutation.
- Anecdotal reports suggest potential efficacy of BRAF inhibitors in refractory multiple myeloma.
Findings:
- The study reports the first use of vemurafenib and cobimetinib combination in a BRAF V600E-mutated multiple myeloma patient.
- The patient achieved a rapid and sustained response to the combination therapy.
Implications:
- This case suggests that combined BRAF and MEK inhibition may be a viable therapeutic strategy for BRAF-mutated multiple myeloma.
- Further research is warranted to explore the efficacy of this combination in a larger cohort of multiple myeloma patients.
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