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

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  • Hosoya Ryusaku
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Sakashita Hiroyuki
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital Department of Chemotherapy, Yokosuka Kyosai Hospital
  • Yamada Takayuki
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Sawada Atsushi
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Kumagai Takashi
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Izumi Makoto
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Watabe Haruna
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Kamoshida Tatsuhiko
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Yasuda Takehiro
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital
  • Tominaga Shinichiro
    Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital

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Other Title
  • ダブラフェニブ＋トラメチニブ投与中に完全房室ブロックと共に左室収縮機能障害を呈したがダブラフェニブ単剤にすることで治療継続できた1例

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<p>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.</p>

Journal

  • Haigan

    Haigan 63 (1), 58-63, 2023-02-20

    The Japan Lung Cancer Society

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