ArticleFrontiers in oncology2026
Durable complete response to pembrolizumab after BRAF/MEK inhibition in recurrent MSI-H/dMMR, BRAF V600E-mutant colon cancer: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Patients with metastatic colorectal cancer (mCRC) harboring both microsatellite instability-high/deficient mismatch repair (MSI-H/dMMR) and the BRAF V600E mutation represent a distinct clinicomolecular subgroup characterized by aggressive biology and distinct therapeutic challenges. While MSI-H/dMMR predicts sensitivity to immune checkpoint inhibitors (ICIs), the concurrent BRAF V600E mutation may contribute to secondary resistance or shortened durability of response in a subset of patients treated with ICI monotherapy. Here, we present the case of an 85-year-old female with locally advanced ascending colon cancer who experienced rapid recurrence and metastasis only four months after radical surgery. Molecular profiling confirmed MSI-H, dMMR, and BRAF V600E mutation. Given her advanced age and frailty, she was treated with a first-line combination of pembrolizumab, dabrafenib, and trametinib. Although the targeted therapy (dabrafenib/trametinib) was discontinued after approximately two months due to recurrent high-grade pyrexia, the patient continued on pembrolizumab maintenance. She achieved a radiographic complete response (CR) and has remained progression-free for over 26 months. This case highlights the potential synergy between MAPK pathway inhibition and immunotherapy, suggesting that even short-course targeted therapy may favorably remodel the tumor microenvironment to enable durable disease control in high-risk MSI-H/BRAF-mutant mCRC.
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