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Case Reports: Adverse drug reactions and complications
Large-vessel vasculitis possibly induced by BRAF and MEK inhibitors for BRAF V600E positive lung adenocarcinoma
  1. Kento Ichikawa1,
  2. Shigeru Ohno1,
  3. Sousuke Kubo2 and
  4. Hideaki Nakajima3
  1. 1Center for Rheumatic Diseases, Yokohama City University Medical Center, Yokohama, Japan
  2. 2Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
  3. 3Department of Stem Cell and Immune Regulation, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
  1. Correspondence to Dr Kento Ichikawa; ichikawa.ken.jn{at}yokohama-cu.ac.jp

Abstract

The combination therapy of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) and mitogen-activated protein kinase kinase (MEK) inhibitors is approved for treating patients with BRAF V600E-positive tumours, including melanoma and lung cancer. Several case reports indicated autoimmune side effects associated with the use of BRAF and MEK inhibitors. Still, the effects of these drugs on the immune system were not fully elucidated. Here, we report a patient with large-vessel vasculitis diagnosed after initiation of treatment with dabrafenib and trametinib for BRAF V600E-positive metastatic lung adenocarcinoma. She was a never-smoker woman in her early 70s who presented with a chronic cough and was diagnosed with BRAF V600E-positive metastatic lung adenocarcinoma by transbronchial lung biopsy. She was successfully treated with prednisolone and methotrexate while BRAF and MEK inhibitors were continued. We should be careful about autoimmune diseases using BRAF and MEK inhibitors.

  • Vasculitis
  • Lung cancer (oncology)
  • Malignant disease and immunosuppression

https://doi.org/10.1136/bcr-2023-255958

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    Footnotes

    • Contributors KI, SO and SK were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. KI substantially contributed to the manuscript drafting. KI, SO and SK were directly involved in the patient’s care. SO, SK and HN critically reviewed and revised the manuscript draft and approved the final version for submission. HN gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.