Nivolumab in combination with dabrafenib and trametinib use in advanced cholangiocarcinoma with a BRAF V600E mutation and severe hepatic dysfunction: A case report and review of the literature

Introduction: Cholangiocarcinomas (CCA) are rare, aggressive tumors often diagnosed in advanced stages with limited evidence guiding therapy on progression. Case Report: We report a case of CCA rapid and aberrant progression, refractory to multiple lines therapy, that resulted severe hepatic dysfunction secondary tumor burden BRAF V600E mutation high proportion score (TPS) 99%. To our knowledge, this is the first reported use BRAF/MEK inhibition target patient leading normalization patient’s liver within days. No adverse events were recorded during either initial titration or maintenance periods. Programmed death-1 (PD-1) inhibitor was added inhibition, continues have clinical therapeutic response. Conclusion: This highlights mutations due role combining immune checkpoint inhibitors.