BRAF in lung cancer: A narrative review

Abstract

Testing for the presence of oncogenic driver mutations in non-small-cell lung cancer (NSCLC) is a therapeutic mandate, and hence, in-depth knowledge of all the targetable biomarkers is essential. Apart from the well-known driver mutations in epidermal growth factor receptor, anaplastic lymphoma kinase, and ROS1, mutations in BRAF comprise an important molecular subtype of NSCLC, which is amenable to targeted therapy. In this review, we have described the molecular biology, detection methods, and various treatment modalities available for patients with NSCLC harboring BRAF mutations. We searched the PubMed, Embase, Scopus, and My Cancer Genome databases using the keywords, “BRAF,” “NSCLC,” “vemurafenib,” “dabrafenib,” and “trametinib.” A total of 44 articles were included in the review. Although targeted therapies have been successfully used in the management of advanced NSCLCs with BRAF mutations, it is necessary for clinicians to be mindful of the nuances of BRAF testing and interpretation of the results. Judicious use of BRAF inhibitors, either in the first or second line, can lead to improved survival in this subgroup of patients. In addition, immunotherapeutic agents may have a role in BRAF-mutant NSCLCs, in contrast to other oncogene-addicted NSCLCs where they are contraindicated.