Remarkable Response to Dabrafenib and Trametinib in a V-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) V600E-Mutated Lung Adenocarcinoma Patient With Poor Performance Status and Respiratory Failure: A Case Report

We report the case of a 73-year-old man with progressive dyspnea and acute respiratory failure. Imaging revealed extensive infiltrative shadows in the right lung. A bronchoscopic biopsy confirmed primary lung adenocarcinoma harboring the BRAF V600E mutation. The patient's performance score was three, requiring four liter/minute of supplemental oxygen to maintain an oxygen saturation of 90%. After a thorough discussion and informed consent, treatment with dabrafenib and trametinib was initiated despite the risks associated with his condition. Following the initiation of therapy, the patient exhibited significant clinical and radiological improvements. He continues to receive the combination therapy without significant adverse events, and his disease remains stable. We report this as the first case that demonstrates dabrafenib and trametinib can be effective and well-tolerated in patients with BRAF V600E mutated non-small cell lung cancer (NSCLC), even in those with poor performance status and acute respiratory failure. This result provides early evidence supporting the cautious use of molecular-targeted therapies in such patients.