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Upfront progression under pembrolizumab followed by a complete response after encorafenib and cetuximab treatment in BRAF V600E-mutated and microsatellite unstable metastatic colorectal cancer patient: A case report
- Source :
- Genes, chromosomescancerREFERENCES. 61(2)
- Publication Year :
- 2021
-
Abstract
- Two new treatments have recently become standard of care for patients with metastatic colorectal cancer (mCRC): encorafenib (BRAF inhibitor) associated with cetuximab (anti-EGFR) in the second or third line of chemotherapy for BRAF V600E tumors, and pembrolizumab (an anti PD-1 immune checkpoint inhibitor) for tumors harboring microsatellite instability (MSI)-high and/or deficient mismatch repair (dMMR). Furthermore, 30% of BRAF V600E mutated mCRC are MSI/dMMR through a sporadic hypermethylation of the promoter of hMLH1. We report here, for the first time, the case of a patient with BRAF V600E, PIK3CA and SMAD4 mutated and dMMR/MSI mCRC, in whom we observed an atypical response pattern under the sequence of pembrolizumab followed by the doublet encorafenib and cetuximab treatment. The patient was progressive after a single cycle of pembrolizumab followed by a rapid complete response after only two months of treatment with encorafenib and cetuximab, discovered during R0 cyto-reduction surgery for peritoneal carcinomatosis. This article is protected by copyright. All rights reserved.
- Subjects :
- Oncology
Proto-Oncogene Proteins B-raf
Cancer Research
medicine.medical_specialty
Colorectal cancer
Colon
medicine.medical_treatment
Cetuximab
Antineoplastic Agents
Pembrolizumab
Biology
Antibodies, Monoclonal, Humanized
Internal medicine
Encorafenib
Genetics
medicine
Humans
neoplasms
Chemotherapy
Sulfonamides
Microsatellite instability
Immunotherapy
DNA Methylation
Middle Aged
medicine.disease
digestive system diseases
Mutation
Disease Progression
DNA mismatch repair
Female
Microsatellite Instability
Carbamates
Colorectal Neoplasms
medicine.drug
Subjects
Details
- ISSN :
- 10982264
- Volume :
- 61
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Genes, chromosomescancerREFERENCES
- Accession number :
- edsair.doi.dedup.....098ba7a5314b7f57c1b711ed48c6c30b