Response to the combination of osimertinib, dabrafenib and trametinib in leptomeningitis from EGFR-mutant NSCLC with acquired BRAF V600E mutation: a case report

Abstract Molecular sequencing after highly potent targeted-gene inhibitors suggests resistant tumors can display significant heterogeneity. Among this various mechanisms of resistance, secondary mutations on targetable oncogenes has been identified. BRAF V600E as by-pass mechanism upon disease progression while receiving osimertinib therapy has been reported in 3% of EGFR-mutated patients. Few case reports described the efficacy of the association of osimertinib and dabrafenib plus trametinib. Here, we report for the first time a case of a patient treated with this association with prolonged response on leptomeningeal metastasis. We also provide a comprehensive overview of the available literature on the efficacy and tolerance of this association.