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Prolonged Response to Dabrafenib/Trametinib in Grade 3 Metastatic Pancreatic Neuroendocrine Tumor (NET G3) with BRAF
Benjamin E Ueberroth1, Christopher H Lieu2, Robert W Lentz2
1Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, 12801 E 17th Ave, MS 8117, Aurora, CO, 80045, USA. benjamin.ueberroth@cuanschutz.edu.
Purpose:
Treatment of metastatic pancreatic neuroendocrine tumors (pancNETs), particularly grade 2 (G2) and grade 3 (G3), often presents a dilemma in choosing from multiple similarly efficacious therapies. Data on targeted therapies for these tumor types is limited, and this report presents BRAF-targeted therapy as a therapeutic option for metastatic pancNET G3.
Methods:
This is a case report of a patient with G3 pancNET metastatic to the liver, lung, lymph node, and scalp (soft tissue) treated with dabrafenib/trametinib (D/T) in the presence of a BRAF V600E mutation detected in tumor tissue.
Results:
This patient has demonstrated an ongoing partial response to therapy at all involved sites for nearly 15 months with minimal side effects attributable to D/T.
Conclusion:
Dabrafenib/trametinib therapy for BRAF-mutated metastatic pancNETs provides a novel treatment option and, especially in the G3 setting, should be considered a first-line option. Tumor testing for actionable mutations should be undertaken at the time of diagnosis and/or progression to identify novel therapeutic avenues in these rare tumors.
Insights
BRAF-targeted therapy with dabrafenib/trametinib offers a new treatment option for metastatic pancreatic neuroendocrine tumors (pancNETs) with BRAF V600E mutations. This targeted approach shows promise, particularly for grade 3 pancNETs.
Area of Science:
- Oncology
- Molecular Diagnostics
- Pharmacology
Background:
- Metastatic pancreatic neuroendocrine tumors (pancNETs), especially grade 2 and 3, present treatment challenges due to multiple similar therapy options.
- Limited data exists on targeted therapies for these rare tumors.
Purpose of the Study:
- To present BRAF-targeted therapy as a viable treatment option for metastatic pancreatic neuroendocrine tumors grade 3 (pancNET G3).
Main Methods:
- A case report detailing a patient with metastatic G3 pancNET (liver, lung, lymph node, scalp) harboring a BRAF V600E mutation.
- Treatment administered was dabrafenib/trametinib (D/T).
Main Results:
- The patient achieved an ongoing partial response across all metastatic sites for nearly 15 months.
- Minimal side effects were observed with the D/T therapy.
Conclusions:
- Dabrafenib/trametinib therapy is a novel treatment option for BRAF-mutated metastatic pancNETs.
- This therapy should be considered a first-line option for G3 pancNETs.
- Testing for actionable mutations at diagnosis or progression is crucial for identifying new therapeutic strategies.
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