Response to BRAF/MEK Inhibition After Progression With BRAF Inhibition in a Patient With Anaplastic Pleomorphic Xanthoastrocytoma

Neurologist. 2018 Sep;23(5):163-166. doi: 10.1097/NRL.0000000000000194.

Abstract

Pleomorphic xanthoastrocytoma (PXA) is a rare primary central nervous system tumor which frequently harbors mutations in BRAF. Anaplastic PXA follow a more aggressive course than their nonanaplastic counterparts. We present the case of an anaplastic PXA initially treated with the BRAF inhibitor vemurafenib. After progression of disease the MEK inhibitor trametinib was added to the regimen leading to radiographic improvement. The rationale for combined BRAF and MEK inhibition in PXA is reviewed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Astrocytoma / diagnostic imaging
  • Astrocytoma / drug therapy
  • Astrocytoma / metabolism*
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / metabolism*
  • Disease Progression
  • Enzyme Inhibitors / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mitogen-Activated Protein Kinase Kinases / metabolism*
  • Proto-Oncogene Proteins B-raf / metabolism*

Substances

  • Enzyme Inhibitors
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Mitogen-Activated Protein Kinase Kinases