Neoantigen and MMR Gene Methylation Analysis of BRAF V600e Mutated Non-Small Cell Lung Cancer to Predict the Response of Immunotherapy

Abstract

Introduction

Non-small cell lung cancer (NSCLC) exhibits a multitude of oncogenic mutations, prompting extensive research into various treatment modalities, including targeted therapy and immunotherapy. Among these treatments, when the BRAF V600E mutation is identified in NSCLC cases, the National Comprehensive Cancer Network guidelines recommend the use of dabrafenib plus trametinib or vemurafenib/dabrafenib as either f irst-line or subsequent therapy options [1].

The incidence of BRAF mutations in NSCLC comprises approximately 3–5%, with the V600E mutation constituting roughly half of these cases. Notably, this mutation is predominantly identified in lung adenocarcinoma [2]. Studies conducted in Japan and China have reported even lower frequencies of BRAF mutations, accounting for less than 1%, which is anticipated to be even less common in Asian populations [3, 4].

In cases of advanced or metastatic NSCLC, the primary treatment recommendation involves immunotherapy alone or a combination with cytotoxic chemotherapy, particularly when actionable molecular biomarkers are absent. Additionally, immunotherapy as a standalone approach can be considered for subsequent treatment lines [1].