Evidence map›Paper›PMID 40345491›Full record

ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2025

Treatment Sequences in BRAF-V600-Mutated NSCLC: First-Line Targeted Therapy Versus First-Line (Chemo-) Immunotherapy.

Marcel Wiesweg, Ali Alaffas, Anna Rasokat, Felix Carl Saalfeld, Maximilian Rost, Christin Assmann, Franziska Herster, Moritz Hilbrandt, Frank Griesinger, Anna Kron and 14 more

Abstract read
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Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Trial
  2. Updated Efficacy and Safety From the Phase 2 PHAROS Study of Encorafenib Plus Binimetinib in Patients With BRAF V600E-Mutant Metastatic NSCLC-A Brief Report.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2025
    Trial
  3. Article
  4. Cost-Effectiveness of First-Line Immunochemotherapy VersusCurrent oncology (Toronto, Ont.) · 2026
    Article
  5. First-line treatment strategies forJournal of thoracic disease · 2026
    Article
  6. Article
  7. Review
  8. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors.

Marcel WieswegDepartment of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; National Center for Tumor Diseases (NCT), NCT West, Essen, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany. Electronic address: marcel.wiesweg@uk-essen.de.
Ali AlaffasDepartment of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany.
Anna RasokatDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Lung Cancer Group Cologne, University Hospital of Cologne, Cologne, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Felix Carl SaalfeldClinic for Internal Medicine I, University Hospital, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT/UCC), Dresden, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Maximilian RostDepartment of Medicine II, Hematology/Oncology, University Hospital Frankfurt, Frankfurt, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Christin AssmannDepartment of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Franziska HersterRobert Bosch Centrum für Tumorerkrankungen Stuttgart, Stuttgart, Germany; National Center for Tumor Diseases (NCT), NCT SouthWest, Stuttgart, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Moritz HilbrandtDepartment of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Germany; National Center for Tumor Diseases (NCT), NCT Berlin, Berlin, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Frank GriesingerDepartment of Hematology and Oncology, Pius-Hospital, University Dept. of Internal Medicine-Oncology, Oldenburg, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Anna KronDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Lung Cancer Group Cologne, University Hospital of Cologne, Cologne, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Julia RoeperDepartment of Hematology and Oncology, Pius-Hospital, University Dept. of Internal Medicine-Oncology, Oldenburg, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Franziska GlanemannDepartment of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Cornelia Kropf-SanchenDivision of Pulmonology, Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Martin ReckLung Clinic Grosshansdorf, Airway Research Center North, German Center of Lung Research, Grosshansdorf, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Jonas KulhavyTranslational Oncology/Early Clinical Trial Unit (ECTU), Comprehensive Cancer Center Mainfranken and Bavarian Cancer Research Center (BZKF), University Hospital Würzburg, Würzburg, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Albrecht StenzingerInstitute of Pathology, University Hospital Heidelberg, Heidelberg, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Jürgen WolfDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Lung Cancer Group Cologne, University Hospital of Cologne, Cologne, Germany; National Center for Tumor Diseases (NCT), NCT West, Cologne, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Martin SebastianDepartment of Medicine II, Hematology/Oncology, University Hospital Frankfurt, Frankfurt, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Martin SchulerDepartment of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; National Center for Tumor Diseases (NCT), NCT West, Essen, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Martin WermkeClinic for Internal Medicine I, University Hospital, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), NCT SouthWest, Stuttgart, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Nikolaj FrostDepartment of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Germany; National Center for Tumor Diseases (NCT/UCC), Dresden, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Hans-Georg KoppRobert Bosch Centrum für Tumorerkrankungen Stuttgart, Stuttgart, Germany; National Center for Tumor Diseases (NCT), NCT SouthWest, Stuttgart, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Petros ChristopoulosDepartment of Thoracic Oncology, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany; National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.
Matthias SchefflerDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Lung Cancer Group Cologne, University Hospital of Cologne, Cologne, Germany; National Center for Tumor Diseases (NCT), NCT West, Cologne, Germany; nNGM, National Network Genomic Medicine Lung Cancer, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTargeted treatment of patients with metastatic BRAF-V600-mutated NSCLC using BRAF/MEK-inhibitors is effective but limited by acquired resistance. Patients with BRAF-mutant NSCLC may derive long-lasting benefit from immune checkpoint inhibition with programmed death-1/programmed death-ligand 1 (PD-L1) antibodies (immuno-oncology [IO]). Although IO is the preferred first-line therapy in BRAF-mutated melanoma, the optimal treatment sequence in BRAF-mutated NSCLC is not defined.

methodsThis retrospective study investigated the clinical outcome of patients with metastatic BRAF-V600-mutated NSCLC diagnosed in the German national Network Genomic Medicine Lung Cancer.

resultsWe identified 205 patients with BRAF-V600-mutated NSCLC; 175 patients received first-line therapy with dabrafenib/trametinib (DAB/TRM, 65.1%), IO alone (19.4%), or chemotherapy-IO (15.4%). Overall survival (OS) and time-to-treatment failure of first-line therapy was identical for patients receiving first-line DAB/TRM (median OS 28.0 months) or chemo/IO (27.8 months, hazard ratio [HR] 1.1, p = 0.68). Female patients had superior OS (HR 0.65, p = 0.049, confirmed in multivariate model), which was mainly driven by superior OS of female to that of male patients receiving first-line DAB/TRM (OS HR 0.53, p = 0.015). There was no sex difference in survival of patients receiving IO-based first-line treatment (OS HR 1.02). Surprisingly, high PD-L1 status (tumor proportion score ≥50%) was associated with shortened time-to-treatment failure in first-line treatment (HR 1.83, p = 0.002, confirmed in multivariate models adjusting for sex; OS with nonsignificant trend, HR 1.4), regardless of whether the first-line regimen was IO-based or targeted therapy.

conclusionsTargeted or IO-based first-line treatment of BRAF-V600-mutated NSCLC has similar survival outcomes. Sex and PD-L1 status may support decision-making at the individual patient level.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungImmunotherapyLung NeoplasmsMolecular Targeted TherapyMutationProto-Oncogene Proteins B-rafAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesBRAF protein, humanProto-Oncogene Proteins B-rafBRAFImmunotherapyNSCLCPD-L1Sex

Identifiers

PMID40345491

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.