Tumor flare after start of RAF inhibition in KRAS mutated NSCLC: A case report

作者：Mellema Wouter W; Burgers Sjaak A; Smit Egbert F^*

来源：Lung Cancer, 2015, 87(2): 201-203.

DOI：10.1016/j.lungcan.2014.11.014

• Non-small cell lung cancer
• KRAS mutation
• Sorafenib
• RAF inhibitor
• Paradoxal activation
• Tumor flare

Here we describe a case of striking tumor flare after start of treatment with sorafenib and metformin as part of a phase II clinical trial. Previous reports have described a paradoxal activation of the MAPK pathway after treatment with a weak RAF inhibitor. This mechanism is based on inhibition of a negative feedback loop to upstream effectors of RAF and subsequently increased stimulation of the RAS-RAF-MEK-ERK (MAPK) pathway. We suggest that sorafenib may contribute to tumor progression through this mechanism and clinicians should be aware of this phenomenon when treating NSCLC patients with sorafenib.

• 出版日期2015-2