Background: The BRAFV600E mutation is the most common driver mutation in papillary thyroid cancer (PTC) and anaplastic thyroid cancer (ATC). This mutation is considered actionable and, for BRAFV600E-mutated ATC, a BRAF inhibitor (dabrafenib) in combination with an MEK inhibitor (trametinib) is FDA approved. BRAF inhibitors have also shown efficacy in BRAFV600E-mutated PTC. However, as with all targeted therapies, resistance to these drugs eventually develops. It is essential that we understand the mechanisms of resistance to the BRAF inhibitors in thyroid cancer to develop future strategies to effectively treat these patients and improve survival. Patients: Herein, we describe four patients with thyroid cancer treated with selective BRAF inhibitors, who developed a RAS mutation in addition to the BRAFV600E mutation at progression. Results: Patients 1 and 3 acquired a KRASG12V mutation in the progressive tumor, patient 2 acquired a NRASQ61K mutation in a progressive lymph node, and patient 4 acquired NRASG13D mutation on liquid biopsy performed at the time of radiographic disease progression. Conclusion: Similar to the melanoma experience, the emergence of RAS mutations appears to act as a mechanism of resistance to BRAF inhibitors in thyroid cancers.
Background: The BRAFV600E mutation is the most common driver mutation in papillary thyroid cancer (PTC) and anaplastic thyroid cancer (ATC). This mutation is considered actionable and, for BRAFV600E-mutated ATC, a BRAF inhibitor (dabrafenib) in combination with an MEK inhibitor (trametinib) is FDA approved. BRAF inhibitors have also shown efficacy in BRAFV600E-mutated PTC. However, as with all targeted therapies, resistance to these drugs eventually develops. It is essential that we understand the mechanisms of resistance to the BRAF inhibitors in thyroid cancer to develop future strategies to effectively treat these patients and improve survival. Patients: Herein, we describe four patients with thyroid cancer treated with selective BRAF inhibitors, who developed a RAS mutation in addition to the BRAFV600E mutation at progression. Results:Patients 1 and 3 acquired a KRASG12V mutation in the progressive tumor, patient 2 acquired a NRASQ61K mutation in a progressive lymph node, and patient 4 acquired NRASG13D mutation on liquid biopsy performed at the time of radiographic disease progression. Conclusion: Similar to the melanoma experience, the emergence of RAS mutations appears to act as a mechanism of resistance to BRAF inhibitors in thyroid cancers.
Authors: Marie-Claude Hofmann; Muthusamy Kunnimalaiyaan; Jennifer R Wang; Naifa L Busaidy; Steven I Sherman; Stephen Y Lai; Mark Zafereo; Maria E Cabanillas Journal: Endocr Relat Cancer Date: 2022-09-14 Impact factor: 5.900
Authors: Mark Lee; Brian R Untch; Bin Xu; Ronald Ghossein; Catherine Han; Fengshen Kuo; Cristina Valero; Zaineb Nadeem; Neal Patel; Vladimir Makarov; Snjezana Dogan; Richard J Wong; Eric J Sherman; Alan L Ho; Timothy A Chan; James A Fagin; Luc G T Morris Journal: Mol Cancer Res Date: 2021-10-11 Impact factor: 6.333
Authors: María San Román Gil; Javier Pozas; Javier Molina-Cerrillo; Joaquín Gómez; Héctor Pian; Miguel Pozas; Alfredo Carrato; Enrique Grande; Teresa Alonso-Gordoa Journal: Int J Mol Sci Date: 2020-07-13 Impact factor: 5.923