AUTHOR=Niu Xiaomin , Sun Yingjia , Planchard David , Chiu Luting , Bai Jian , Ai Xinghao , Lu Shun 

TITLE=Durable Response to the Combination of Atezolizumab With Platinum-Based Chemotherapy in an Untreated Non-Smoking Lung Adenocarcinoma Patient With BRAF V600E Mutation: A Case Report

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.634920

DOI=10.3389/fonc.2021.634920

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Immune checkpoint inhibitor (ICPi) has become a major treatment in advanced non-small cell lung cancer (NSCLC) and demonstrated a clinical benefit for NSCLC patients with high programmed death ligand-1 (PD-L1) expression without <italic>EGFR/ALK/ROS1</italic> drivers; however, the benefit in <italic>BRAF</italic> V600E NSCLC is so far unknown. Here, we report a case of prolonged tumor response to the combination of immunotherapy with chemotherapy in a non-smoking <italic>BRAF</italic> V600E NSCLC patient.</p></sec><sec><title>Materials and Methods</title><p>We verify a co-expression of <italic>BRAF</italic> V600E mutation and PD-L1 high expression more than 50% on formalin-fixed paraffin-embedded tumor sample of a newly diagnosed lung adenocarcinoma patient by immunohistochemistry and <italic>BRAF</italic> V600E/<italic>EGFR</italic>/<italic>ALK</italic>/<italic>ROS1</italic> Mutations Detection Kit. The tissue and liquid biopsies were further subjected to next-generation sequencing (NGS) for identification of mutations with progression on immunotherapy and BRAF inhibitor (BRAFi). The patient had provided written informed consent and authorized the publication of clinical case.</p></sec><sec><title>Results</title><p>We demonstrate the case of 62-year-old female non-smoker with high PD-L1 expression and <italic>BRAF</italic> V600E mutated NSCLC. The progression-free survival (PFS) of first-line combination of atezolizumab with platinum-based chemotherapy and sequential second-line treatment with BRAFi Vemurafenib are 20 and 5.5 months, respectively.</p></sec><sec><title>Conclusion</title><p>This case shows a durable response to ICPi in <italic>BRAF</italic> V600E non-smoking lung adenocarcinoma with PFS of 20 months under first-line atezolizumab plus chemotherapy treatment. The case supports the idea that the combination immunotherapy may be an attractive option for <italic>BRAF</italic> V600E mutated non-smoking NSCLC with high PD-L1 expression.</p></sec>