Near complete remission of an inoperable pancreatic acinar cell carcinoma after BRAF‐/MEK‐inhibitor treatment—A case report and review of the literature

Abstract

AbstractIntroductionPancreatic acinar cell carcinomas are rare malignant neoplasms. High‐quality evidence about the best treatment strategy is lacking. We present the case of a 52‐year‐old male with a BRAFV600E‐mutated PACC who experienced a complete remission after chemotherapy with BRAF‐/MEK‐inhibitors.CaseThe patient presented with upper abdomen pain, night sweat, and weight loss. CT scan showed a pancreatic tumor extending from the pancreas head to body. Histological workup identified an acinar cell carcinoma. As the tumor was inoperable, chemotherapy with FOFIRNIOX was initiated and initially showed a slight regression of disease. The regimen had to be discontinued due to severe side effects. Molecular analysis identified a BRAFV600E mutation, so the patient was started on BRAF‐ and MEK‐inhibitors (dabrafenib/trametinib). After 16 months, CT scans showed a near complete remission with a markedly improved overall health.DiscussionStudies suggest that up to one‐fourth of PACCs carry a BRAF mutation and might therefore be susceptible to a BRAF‐/MEK‐inhibitor therapy. This offers a new therapeutic pathway to treat this rare but malignant neoplasm.