Not all lung cancers are the same. In fact, lung cancers may differ from one another based on what genes have mutations, and “genomic testing” can be performed on a tissue or liquid biopsy sample of the cancer to identify the specific genetic abnormality driving the growth of a specific lung cancer. Once the cancer driving mutation is identified a specific precision cancer medicine or immunotherapy can be used to attack that specific mutation or other cancer-related change in the DNA programming of the cancer cells.
Since 2015 over 15 new precision cancer medicines have been developed and approved for the treatment of specific lung cancer causing genetic mutations. All patients should undergo genomic biomarker testing at the time of diagnosis or lung cancer recurrence in order to determine if they have a treatable mutation or are eligible for participation in a clinical trial evaluating newer precision cancer medicines and immunotherapies.
Precision cancer medicines can be used both instead of and in addition to chemotherapy to improve treatment outcomes. Testing an individual’s lung cancer for specific biomarkers and genomic alterations allow doctors to identify cancer driving genetic mutations and offer the most personalized treatment approach utilizing precision medicines. Individuals with lung cancer should undergo genomic testing to determine whether newer precision cancer medicines are a treatment option.
BRAF & MEK Kinase Inhibitors
The BRAF and MEK genes are known to play a role in cell growth, and mutations of these genes occur in non-small cell lung cancers (NSCLC). This mutation produces an abnormal version of the BRAF kinase that stimulates cancer growth. Some cancers carry another mutation known as V600K. BRAF and MEK inhibitors block the activity of the V600E and V600K mutations respectively and the combination of a BRAF and MEK Inhibitor a standard treatment for individuals with NSCLC and these cancer driving mutations.
On October 11, 2023, the Food and Drug Administration approved Braftovi (encorafenib) with Mektovi (binimetinib) for adult patients with metastatic non-small cell lung cancer (NSCLC) with a BRAF V600E mutation.
BRAF Inhibitors
- Zelboraf®(vemurafenib) BRAF V600E kinase inhibitor
- Tafinlar®(dabrafenib)BRAF V600E kinase inhibitor
- Braftovi (encorafenib)BRAF V600E kinase inhibitor
MEK inhibitors
- Mekinist®(trametinib) MEK V600 kinase inhibitor
- Cotellic® (cobimetinib)MEK V600 kinase inhibitor
- Mektovi (binimteinib) MEK V600 kinase inhibitor
The combination of a BRAF and a MEK inhibitor decreases the emergence of disease resistance that occurs in patients treated with a BRAF mutation. The combination of Taflinar plus Mekinist has been FDA approved2 and the Braftovi-Mektovi combination represent and additional treatment option.
The Braftovi-Mektovi combination was evaluated as initial therapy in 98 patients with metastatic NSCLC with a BRAF V600E mutation. The objective response rate was 75% with a median duration of response not reached and among 39 previously treated patients, the response rate was 46% with a median response duration of 16.7 months.
Connect With Others for Support and information
Cancer Connect was the first social network created for people with lung cancer. Founded by oncologists to support cancer patients and their caregivers, over 40 million individuals have accessed Cancer Connect programs since 1997. Cancer Connect is used by leading cancer centers like Dana Farber, Roswell Park and The James at Ohio State to support their patients. Join the conversation, ask questions, share your experience, and learn how the best cancer centers are treating cancer from others. Share your experience, ask a question, or start a conversation by posting on Cancer Connect.
References
- https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-encorafenib-binimetinib-metastatic-non-small-cell-lung-cancer-braf-v600e-mutation#:~:text=On%20October%2011%2C%202023%2C%20the,as%20detected%20by%20an%20FDA%2D
- http://www.nejm.org/doi/full/10.1056/NEJMoa1714448?query=featured_home
