Combination of BRAF and MEK inhibition in BRAF V600E mutant low-grade ganglioglioma

J Clin Pharm Ther. 2020 Oct;45(5):1172-1174. doi: 10.1111/jcpt.13112. Epub 2020 Jan 27.

Abstract

What is known and objective: Post-surgical management of low grade gangliogliomas is controversial with paucity of data for the use of chemotherapy. BRAF mutations are present in a number of glioma subtypes and offer an opportunity for treatment with targeted therapy.

Case summary: A 32-year-old man with an unresectable, BRAF V600E mutant, WHO grade 1 ganglioglioma is commenced on combination BRAF and MEK inhibition (vemurafenib and cobimetinib). Partial radiological and clinical response was noted after 13 weeks of treatment. Treatment complication with grade 2 skin and liver toxicity was resolved with dose interruption and reduction.

What is new and conclusion: Combination BRAF and MEK inhibition present a safe and feasible treatment strategy in unresectable BRAF V600E mutant low grade ganglioglioma.

Keywords: medication; pharmacogenomics.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Azetidines / administration & dosage
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology
  • Ganglioglioma / drug therapy*
  • Ganglioglioma / genetics
  • Ganglioglioma / pathology
  • Humans
  • Male
  • Mitogen-Activated Protein Kinase Kinases
  • Mutation
  • Piperidines / administration & dosage
  • Proto-Oncogene Proteins B-raf / genetics
  • Vemurafenib / administration & dosage

Substances

  • Azetidines
  • Piperidines
  • Vemurafenib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Mitogen-Activated Protein Kinase Kinases
  • cobimetinib