Near complete remission of an inoperable pancreatic acinar cell carcinoma after BRAF ‐/MEK ‐inhibitor treatment—A case report and review of the literature
Lennart von Fritsch, Nikolas von Bubnoff, Klaus Weber, Jutta Kirfel, Cleopatra Schreiber, Tobias Keck, Ulrich Wellner - Cancer Research
- Genetics
Abstract
Introduction
Pancreatic acinar cell carcinomas are rare malignant neoplasms. High‐quality evidence about the best treatment strategy is lacking. We present the case of a 52‐year‐old male with a BRAFV600E‐mutated PACC who experienced a complete remission after chemotherapy with BRAF‐/MEK‐inhibitors.
Case
The patient presented with upper abdomen pain, night sweat, and weight loss. CT scan showed a pancreatic tumor extending from the pancreas head to body. Histological workup identified an acinar cell carcinoma. As the tumor was inoperable, chemotherapy with FOFIRNIOX was initiated and initially showed a slight regression of disease. The regimen had to be discontinued due to severe side effects. Molecular analysis identified a BRAFV600E mutation, so the patient was started on BRAF‐ and MEK‐inhibitors (dabrafenib/trametinib). After 16 months, CT scans showed a near complete remission with a markedly improved overall health.
Discussion
Studies suggest that up to one‐fourth of PACCs carry a BRAF mutation and might therefore be susceptible to a BRAF‐/MEK‐inhibitor therapy. This offers a new therapeutic pathway to treat this rare but malignant neoplasm.