Case report: Aggressive NSCLC with partial BRG-1 deficiency and KRAS G12C mutation: a case study and treatment challenges

Front Oncol. 2024 Dec 24:14:1515240. doi: 10.3389/fonc.2024.1515240. eCollection 2024.

Abstract

Background: SMARCA4-deficient (BRG-1 deficient) primary thoracic tumors are rare aggressive malignancies associated with poor prognosis. While complete BRG-1 loss is well-documented, the clinical implications of partial BRG-1 deficiency remain unclear. This case report explores a case of mixed lung cancer with partial BRG-1 deficiency and KRAS G12C mutation, highlighting its clinical relevance, treatment challenges, and the importance of comprehensive molecular profiling.

Methods: We performed immunohistochemistry, next-generation sequencing, and PD-L1 expression analysis to characterize the tumor. Treatment included surgical resection, chemotherapy, and immunotherapy.

Case presentation: We present a case of early-stage mixed lung cancer with partial BRG-1 deficiency in a 66-year-old male, treated with surgical resection, chemotherapy, and later, a PD-1 inhibitor. Despite aggressive treatment, rapid progression to brain metastasis was observed, underscoring the need for tailored approaches.

Conclusion: Partial BRG-1 deficiency may lead to aggressive clinical behavior, similar to complete BRG-1 loss. This case emphasizes the importance of comprehensive molecular profiling to guide treatment decisions and suggests further investigation into combined therapeutic strategies, including immunotherapy.

Keywords: KRAS G12C mutation; NSCLC; brain metastasis; chemoimmunotherapy; molecular profiling; partial BRG-1 deficiency.

Publication types

  • Case Reports

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.