关键词: Lung cancer (oncology) Malignant disease and immunosuppression Vasculitis

Mesh : Humans Proto-Oncogene Proteins B-raf / antagonists & inhibitors genetics Female Pyridones / adverse effects therapeutic use Pyrimidinones / therapeutic use adverse effects Lung Neoplasms / drug therapy Aged Adenocarcinoma of Lung / drug therapy Imidazoles / adverse effects therapeutic use Oximes / adverse effects therapeutic use Vasculitis / chemically induced Protein Kinase Inhibitors / adverse effects therapeutic use Prednisolone / therapeutic use Methotrexate / therapeutic use adverse effects Antineoplastic Combined Chemotherapy Protocols / adverse effects therapeutic use

来  源:   DOI:10.1136/bcr-2023-255958   PDF(Pubmed)

Abstract:
The combination therapy of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) and mitogen-activated protein kinase kinase (MEK) inhibitors is approved for treating patients with BRAF V600E-positive tumours, including melanoma and lung cancer. Several case reports indicated autoimmune side effects associated with the use of BRAF and MEK inhibitors. Still, the effects of these drugs on the immune system were not fully elucidated. Here, we report a patient with large-vessel vasculitis diagnosed after initiation of treatment with dabrafenib and trametinib for BRAF V600E-positive metastatic lung adenocarcinoma. She was a never-smoker woman in her early 70s who presented with a chronic cough and was diagnosed with BRAF V600E-positive metastatic lung adenocarcinoma by transbronchial lung biopsy. She was successfully treated with prednisolone and methotrexate while BRAF and MEK inhibitors were continued. We should be careful about autoimmune diseases using BRAF and MEK inhibitors.
摘要:
v-Raf鼠肉瘤病毒癌基因同源物B1(BRAF)和丝裂原活化蛋白激酶激酶(MEK)抑制剂的联合治疗被批准用于治疗BRAFV600E阳性肿瘤患者,包括黑色素瘤和肺癌.一些病例报告显示与使用BRAF和MEK抑制剂相关的自身免疫副作用。尽管如此,这些药物对免疫系统的影响尚未完全阐明。这里,我们报道了1例因BRAFV600E阳性转移性肺腺癌开始接受达拉非尼和曲美替尼治疗后诊断为大血管血管炎的患者.她是70年代初从不吸烟的女性,患有慢性咳嗽,经支气管肺活检被诊断为BRAFV600E阳性转移性肺腺癌。她用泼尼松龙和甲氨蝶呤成功治疗,同时继续使用BRAF和MEK抑制剂。我们应该小心使用BRAF和MEK抑制剂的自身免疫性疾病。
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