Neoadjuvant combination treatment with checkpoint inhibitors, chemotherapy, and BRAF/MEK inhibitors for BRAF

Publication Title

Neurooncol Adv

Authors

Naveed Wagle, Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Saint Monica, California, USA.Follow
Akanksha Sharma, Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Saint Monica, California, USA.Follow
Minhdan Nguyen, Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Saint Monica, California, USA.Follow
Judy D Truong, Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Saint Monica, California, USA.Follow
Tiffany Juarez, Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Saint Monica, California, USA.Follow
Santosh Kesari, Pacific Neuroscience Institute, Saint John's Cancer Institute, Providence Saint John's Health Center, Saint Monica, California, USA.Follow

Document Type

Article

Publication Date

1-1-2024

Keywords

BRAFV600E; case report; checkpoint inhibitors; glioblastoma; neoadjuvant.; california; sjci; pni

Abstract

Radiation's confounding and adverse effects on tumor microenvironment and normal brain could potentially be delayed by upfront combination treatment. We present a patient with newly diagnosed BRAF V600E-mutant, PD-L1-positive glioblastoma treated with off-label RAF/MEK inhibitors encorafenib/binimetinib after progressing on postoperative immune checkpoint blockade and temozolomide (no radiation administered: NCT03425292). Complete response occurred 6 months after adding encorafenib/binimetinib, and clinical benefit was sustained for over 20 months. Treatment was well tolerated with manageable toxicities, with quality of life and cognitive function maintained throughout treatment. Adding encorafenib/binimetinib to immunotherapy and temozolomide conferred favorable and lasting efficacy for our BRAF V600E -mutant glioblastoma patient, justifying future studies.

Area of Special Interest

Cancer

Area of Special Interest

Neurosciences (Brain & Spine)

Specialty/Research Institute

Oncology

Specialty/Research Institute

Neurosciences

DOI

10.1093/noajnl/vdae110