The clinical response to vemurafenib in a patient with a rare BRAFV600DK601del mutation-positive melanoma.

Abstract:

BACKGROUND:Mutations in the activation segment of the v-raf murine sarcoma viral oncogene homolog B (BRAF) gene are present in approximately 50% of melanomas. The selective BRAF inhibitor vemurafenib has demonstrated significant clinical benefits in patients with melanomas harboring the most common mutations (V600E, V600K and V600R). However, the clinical activity of BRAF inhibitors in patients with rare mutations of codon 600 and the surrounding codons has not been documented. CASE PRESENTATION:We used the BRAF inhibitor vemurafenib to treat a patient presenting a rare p.V600_K601delinsD-mutated melanoma. An objective response was evidenced by two months of progression-free survival. By cloning and sequencing BRAF exon 15, we confirmed that a dual mutation was present on a single allele and thus resulted in a BRAFV(600DK601del) mutant protein. We also performed an in silico crystal structure analysis of the mutated protein, in order to characterize the nature of the putative interaction between vemurafenib and the mutant protein. CONCLUSION:This clinical experience suggests that (i) patients with BRAFV(600DK601del)-mutation-positive melanoma can be treated successfully with the oral BRAF inhibitor vemurafenib and (ii) molecular screening in this context should encompass rare and complex mutations.

journal_name

BMC Cancer

journal_title

BMC cancer

authors

Trudel S,Odolczyk N,Dremaux J,Toffin J,Regnier A,Sevestre H,Zielenkiewicz P,Arnault JP,Gubler B

doi

10.1186/1471-2407-14-727

subject

Has Abstract

pub_date

2014-09-29 00:00:00

pages

727

issn

1471-2407

pii

1471-2407-14-727

journal_volume

14

pub_type

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