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Vol.63 No.1 contents | Japanese/English |
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- Case Report -
A Case of Left Ventricular Contractile Dysfunction with Complete Atrioventricular Block During Administration of Dabrafenib Plus Trametinib in Which Treatment Was Able to Be Continued with Dabrafenib Alone
Ryusaku Hosoya1, Hiroyuki Sakashita1,2, Takayuki Yamada1, Atsushi Sawada1, Takashi Kumagai1, Makoto Izumi1, Haruna Watabe1, Tatsuhiko Kamoshida1, Takehiro Yasuda1, Shinichiro Tominaga11Department of Respiratory Internal Medicine, 2Department of Chemotherapy, Yokosuka Kyosai Hospital, Japan
Background. Although BRAF mutation-positive cases of non-small cell lung cancer are rare, a high overall response rate and prolonged overall survival can be expected; therefore, dabrafenib plus trametinib is recommended as the first-line treatment. Case. In an 81-year-old man, a nodular shadow was noted in the lower right lung field during a medical examination. Primary lung cancer was suspected, and a close examination resulted in a diagnosis of BRAF mutation-positive lung adenocarcinoma, cT4N3M0, cStage IIIC. Dabrafenib plus trametinib was started as the first-line treatment. Three months after the treatment, lower leg edema and dyspnea during exertion appeared. Complete atrioventricular block was observed, and the left ventricular ejection fraction decreased from 61.3% to 39.9% on echocardiography. No other obvious cause could be identified, so adverse events due to dabrafenib plus trametinib were suspected. Dabrafenib plus trametinib was discontinued, and pacemaker placement and a cardiac catheter examination were performed. The left ventricular ejection fraction improved with drug discontinuation; however, the primary lesion increased two months later. Dabrafenib alone was reduced and restarted. Thereafter, dabrafenib was continued for four months without the appearance of heart disorder. Conclusion. Molecular target drug treatment can be continued using dabrafenib alone.
key words: Non-small cell lung cancer, BRAF/MEK inhibitor, Decreased left ventricular ejection fraction, Complete atrioventricular block
Received: August 9, 2022
Accepted: September 9, 2022
JJLC 63 (1): 58-63, 2023
