Treatment of metastatic pancreatic cancer with concurrent BRAF V600E mutation and germline BRCA2 mutation: a case report

This case highlights that the co-occurrence of BRAF V600E and biallelic BRCA2 mutations may confer a unique clinical phenotype with suboptimal or transient responses to both BRCA-directed therapies (platinum, olaparib) and BRAF/MEK inhibition. It underscores the complexity of precision oncology in PDAC, where genotype does not always predict therapeutic response, potentially due to factors like tumor heterogeneity, stromal barriers, or undiscovered resistance mechanisms. Future large-scale studies are needed to define prognostic implications and explore potential combination strategies (e.g., BRAF/MEK + PARP inhibitors) for this rare molecular cohort.