Clinical Oncology: Case Reports

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Case Report, Clin Oncol Case Rep Vol: 4 Issue: 7

Partial Response to Dual BRAF and MEK Inhibition in a Patient with BRAF-Mutant Pancreatic Acinar Cell Carcinoma Refractory to Chemotherapy: A Case Report and Review of the Literature

Adriana PC Barrichello1*, Allan AL Pereira1, Maria Dirlei FS Begnami2, Marcus Vinicius Grigolon3, Eduarda SC Oliveira4, Gustavo S Fernandes1 

1Division of Medical Oncology, Hospital Sirio-Libanês, Brasília-DF, Brazil

2Division of Pathology, Hospital Sírio-Libanês, São Paulo-SP, Brazil

3Division of Nuclear Medicine, Hospital Sírio-Libanês, Brasília-DF, Brazil

4Universidade de Brasília, Brasília-DF, Brazil

*Corresponding Author:
Adriana PC Barrichello
Division of Medical Oncology
Hospital Sírio-Libanês
Brasília-DF, Brazil
E-mail: [email protected]

Received: May 24, 2021 Accepted: July 07, 2021 Published: July 31, 2021

Citation: Barrichello APC, Pereira AA, Begnami MDFS, Grigolon MV, Oliveira ESC, Fernandes GS (2021) Partial Response to Dual BRAF and MEK Inhibition in a Patient with BRAF-Mutant Pancreatic Acinar Cell Carcinoma Refractory to Chemotherapy: A Case Report and Review of the Literature. Clin Oncol Case Rep 4:7

Abstract

Introduction: Pancreatic Acinar Cell Carcinoma (PACC) is a rare subgroup of pancreatic neoplasms that has a better prognosis compared to Pancreatic Ductal Adenocarcinoma (PDAC). The more indolent evolution of the PACC makes surgical resection the standard treatment for localized disease. In metastatic disease, treatment is not well established. BRAF mutations have been detected in up to 13% of PACC, however, treatment with BRAF and/or MEK inhibitors has not yet been studied.

Case report: We present the case of a 73-year-old man, who has the diagnosis of BRAF-mutated metastatic PACC refractory to chemotherapy regimens. He underwent the combination of dabrafenib (selective BRAF inhibitor) and trametinib (selective MEK inhibitor) and had a partial response after 2 and 6 months from initiation of treatment.

Discussion: This case suggests the hypothesis that the block of the RASâ€?RAFâ€?MAPK pathway with the combination of dabrafenib and trametinib may be an option in patients with BRAF-mutated refractory metastatic PACC.  However, other studies are currently evaluating combinations of BRAF and MEK inhibitors in non-melanoma and non-colorectal cancer BRAF-mutated tumors, that can help confirm the activity of dual MEK/BRAF inhibition as a standard approach in BRAF-mutant PACC.

Keywords: Pancreatic acinar cell carcinoma; Pancreatic neoplasms; BRAF mutations; BRAF inhibitor; MEK inhibitor

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