CNSC-89. BRAF/MEK INHIBITION IN THE TREATMENT OF BRAF-MUTANT HIGH-GRADE GLIOMAS: A FIVE-YEAR INSTITUTIONAL EXPERIENCE

Abstract Treatment for high-grade gliomas following surgical resection usually involves administration of temozolomide and radiotherapy. However, small case series and few case reports have increasingly reported survival benefits in the usage of anti-BRAF therapy in a select population of BRAF-positive grade IV gliomas; however, there is incomplete consensus on when anti-BRAF therapy should be considered. Patient records related to grade IV glioma patients who were treated at the University of Cincinnati from 2021-2025 were reviewed and patient demographic, treatment, tumor genomics, and outcome data were recorded for patients with BRAF-positive mutations determined by molecular testing. Four patients with BRAF-positive grade IV glioma who were treated with BRAF/MEK inhibition following near to total gross resection, temozolomide, and radiotherapy were included for further analysis. Of the 3 patients for whom MGMT methylation status was reported, 2 were found to be MGMT-methylated and 1 was MGMT-unmethylated. Median overall survival following diagnosis was found to be 20 months (range: 7-94 months). Median progression-free survival was found to be 7 months (range: 3-12 months). Our institutional review of BRAF-positive grade IV gliomas suggests that anti-BRAF therapy is able to improve survival outcomes for certain subgroups of high-grade glioma patients. Future prospective studies are necessary to further define treatment algorithms in grade IV gliomas and whether anti-BRAF treatment regimens should receive consideration for first-line therapy.