Dual BRAF/MEK blockade restores CNS responses in BRAF-mutant Erdheim-Chester disease patients following BRAF inhibitor monotherapy.

BRAF Cobimetinib Erdheim–Chester disease Vemurafenib histiocytosis

Journal

Neuro-oncology advances
ISSN: 2632-2498
Titre abrégé: Neurooncol Adv
Pays: England
ID NLM: 101755003

Informations de publication

Date de publication:
Historique:
entrez: 10 7 2020
pubmed: 10 7 2020
medline: 10 7 2020
Statut: epublish

Résumé

Erdheim-Chester disease (ECD), a rare inflammatory myeloid neoplasm, is known to be fundamentally reliant on the constitutive activation of the MAPK signaling pathway in the majority of patients. Consequently, inhibition of the V600E-mutant BRAF kinase has proven to be a safe and efficacious long-term therapeutic strategy for We retrospectively describe 3 Three patients with a mean age of 52.6 years were treated with Vemurafenib for a mean duration of 26.6 months (range: 6-52). Monotherapies were upgraded to Vemurafenib/Cobimetinib dual therapy. The combination therapy was administered for a mean duration of 21 months (range: 19-23). All patients exhibited clinical and neurological improvement. Regression of lesions on MRI was noted in 2 patients. Both patients characterized by a PET-avid disease responded to the biological treatment regimen with complete metabolic remissions. Dual inhibition of BRAF and downstream MEK may be a safe and effective therapeutic strategy for

Sections du résumé

BACKGROUND BACKGROUND
Erdheim-Chester disease (ECD), a rare inflammatory myeloid neoplasm, is known to be fundamentally reliant on the constitutive activation of the MAPK signaling pathway in the majority of patients. Consequently, inhibition of the V600E-mutant BRAF kinase has proven to be a safe and efficacious long-term therapeutic strategy for
METHODS METHODS
We retrospectively describe 3
RESULTS RESULTS
Three patients with a mean age of 52.6 years were treated with Vemurafenib for a mean duration of 26.6 months (range: 6-52). Monotherapies were upgraded to Vemurafenib/Cobimetinib dual therapy. The combination therapy was administered for a mean duration of 21 months (range: 19-23). All patients exhibited clinical and neurological improvement. Regression of lesions on MRI was noted in 2 patients. Both patients characterized by a PET-avid disease responded to the biological treatment regimen with complete metabolic remissions.
CONCLUSION CONCLUSIONS
Dual inhibition of BRAF and downstream MEK may be a safe and effective therapeutic strategy for

Identifiants

pubmed: 32642685
doi: 10.1093/noajnl/vdaa024
pii: vdaa024
pmc: PMC7212923
doi:

Types de publication

Journal Article

Langues

eng

Pagination

vdaa024

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA201247
Pays : United States

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.

Références

Nat Rev Clin Oncol. 2013 Jul;10(7):390-9
pubmed: 23712190
Eur J Cancer. 2017 Jul;79:176-184
pubmed: 28501764
Cancer Res. 2016 Mar 15;76(6):1476-84
pubmed: 26825172
Haematologica. 2018 Apr;103(4):e177-e180
pubmed: 29472347
Blood. 2016 Mar 17;127(11):1509-12
pubmed: 26847247
Nature. 2011 Nov 23;480(7377):387-90
pubmed: 22113612
J Invest Dermatol. 2015 Dec;135(12):2913-2918
pubmed: 26569584
Blood. 2013 Feb 28;121(9):1495-500
pubmed: 23258922
N Engl J Med. 2015 Jan 1;372(1):30-9
pubmed: 25399551
Cell Res. 2002 Mar;12(1):9-18
pubmed: 11942415
Orphanet J Rare Dis. 2013 Sep 08;8:137
pubmed: 24011030
Cancer Cell. 2012 Nov 13;22(5):668-82
pubmed: 23153539
Blood. 2011 Mar 10;117(10):2778-82
pubmed: 21239701
Cancer Discov. 2018 Sep;8(9):1130-1141
pubmed: 29880583
Oncologist. 2018 Dec;23(12):1520-1524
pubmed: 30120160
Oncotarget. 2016 May 24;7(21):30907-23
pubmed: 27127178
Cancer Res. 2014 Dec 1;74(23):7079-89
pubmed: 25320010
N Engl J Med. 2012 Dec 13;367(24):2316-21
pubmed: 23134356
Semin Arthritis Rheum. 2012 Jun;41(6):907-13
pubmed: 22300602
Medicine (Baltimore). 1996 May;75(3):157-69
pubmed: 8965684
Nature. 2010 Dec 16;468(7326):973-7
pubmed: 21107323
J Clin Oncol. 2012 Oct 1;30(28):e286-90
pubmed: 22869874
J Pharmacol Exp Ther. 2013 Mar;344(3):655-64
pubmed: 23249624
Blood. 2014 Jul 24;124(4):483-92
pubmed: 24850756
Cancer Discov. 2016 Feb;6(2):154-65
pubmed: 26566875
Cancer Treat Rev. 2013 Dec;39(8):833-8
pubmed: 23845462
N Engl J Med. 2015 Aug 20;373(8):726-36
pubmed: 26287849
J Natl Compr Canc Netw. 2018 Jan;16(1):4-10
pubmed: 29295876
Cancer Discov. 2014 Jan;4(1):27-30
pubmed: 24402945
Nat Med. 2016 Sep;22(9):1056-61
pubmed: 27500726
Am J Ophthalmol. 2001 Dec;132(6):945-7
pubmed: 11730673
Nature. 2010 Mar 18;464(7287):427-30
pubmed: 20179705
Nature. 2010 Dec 16;468(7326):968-72
pubmed: 21107320
Br J Dermatol. 2016 May;174(5):1159-60
pubmed: 26853702
Cancer Discov. 2014 Jan;4(1):80-93
pubmed: 24265155
Blood. 2011 Mar 10;117(10):2783-90
pubmed: 21205927
Ther Adv Respir Dis. 2018 Jan-Dec;12:1753466618767611
pubmed: 29595366
Br J Haematol. 2018 Jan;180(1):150-153
pubmed: 27711968
Cancer Discov. 2014 Jan;4(1):61-8
pubmed: 24265154
Blood. 2012 Sep 27;120(13):2700-3
pubmed: 22879539
Blood. 2017 Sep 14;130(11):1377-1380
pubmed: 28667012
J Clin Oncol. 2015 Feb 10;33(5):411-8
pubmed: 25422482
Cancer Cell. 2010 Dec 14;18(6):683-95
pubmed: 21156289
Expert Rev Clin Immunol. 2015;11(9):1033-42
pubmed: 26197238
N Engl J Med. 2012 Jan 19;366(3):207-15
pubmed: 22256804
Expert Opin Pharmacother. 2014 Apr;15(5):589-92
pubmed: 24456413
N Engl J Med. 2014 Nov 13;371(20):1877-88
pubmed: 25265492
Ann Rheum Dis. 2015 Aug;74(8):1596-602
pubmed: 24671772
N Engl J Med. 2014 Nov 13;371(20):1867-76
pubmed: 25265494

Auteurs

Roei D Mazor (RD)

Clinic of Histiocytic Neoplasms, Institute of Hematology, Assuta Medical Center, Tel Aviv, Israel.

Ran Weissman (R)

Clinic of Histiocytic Neoplasms, Institute of Hematology, Assuta Medical Center, Tel Aviv, Israel.
Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ariel, Israel.
Translational Research Lab, Assuta Medical Centers, Tel-Aviv, Israel.

Judith Luckman (J)

Department of Imaging, Assuta Medical Center, Tel Aviv, Israel.

Liran Domachevsky (L)

Department of Imaging, Assuta Medical Center, Tel Aviv, Israel.
Department of Nuclear Medicine, Assuta Medical Center, Tel Aviv, Israel.

Eli L Diamond (EL)

Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY.

Omar Abdel-Wahab (O)

Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY.

Shirley Shapira (S)

Institute of Hematology, Meir Hospital, Kfar Saba, Israel.
Maccabi Health Services, Tel Aviv, Israel.

Oshrat Hershkovitz-Rokah (O)

Clinic of Histiocytic Neoplasms, Institute of Hematology, Assuta Medical Center, Tel Aviv, Israel.
Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ariel, Israel.
Translational Research Lab, Assuta Medical Centers, Tel-Aviv, Israel.

David Groshar (D)

Department of Imaging, Assuta Medical Center, Tel Aviv, Israel.
Department of Nuclear Medicine, Assuta Medical Center, Tel Aviv, Israel.

Ofer Shpilberg (O)

Clinic of Histiocytic Neoplasms, Institute of Hematology, Assuta Medical Center, Tel Aviv, Israel.
Translational Research Lab, Assuta Medical Centers, Tel-Aviv, Israel.
Pre-Medicine Department, School of Health Sciences, Ariel University, Ariel, Israel.

Classifications MeSH