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Oncology
Small cell transformation in a patient with BRAF V600E-mutated advanced non-small cell lung cancer
  1. Thanakorn Charoenthanadhol1,
  2. Nipon Chaisuriya2 and
  3. Siraphong Putraveephong1
  1. 1Internal Medicine, Khon Kaen University Faculty of Medicine, Khon Kaen, Khon Kaen, Thailand
  2. 2Pathology, Khon Kaen University Faculty of Medicine, Khon Kaen, Khon Kaen, Thailand
  1. Correspondence to Mr Siraphong Putraveephong; b_qule{at}hotmail.com

Abstract

Non-small cell lung cancer (NSCLC) with a BRAF V600E mutation is rare and associated with a worse prognosis compared with wild-type BRAF. The first-line treatment options include a combination of a BRAF inhibitor and a MEK inhibitor or immunotherapy with or without chemotherapy. Unlike advanced NSCLC with common EGFR mutations or ALK rearrangements, the mechanisms of resistance are poorly understood. We report a case of small cell transformation after treatment with a BRAF inhibitor and a MEK inhibitor, which illustrates one potential resistance mechanism. We extrapolated therapeutic data from de novo small cell lung cancer to this case. However, the outcome was unsatisfactory.

  • Oncology
  • Lung cancer (oncology)

https://doi.org/10.1136/bcr-2024-262278

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    Footnotes

    • Contributors The following authors 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: TC. TC acted as guarantor. The following authors gave final approval of the manuscript: SP and NC.

    • 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.