BRAF V600E-mutant intrahepatic cholangiocarcinoma treated successfully with encorafenib, binimetinib, and cetuximab

BRAF mutations, particularly BRAF V600E, are rare but significant molecular alterations in intrahepatic cholangiocarcinoma (IHCC), often associated with aggressive disease and poor prognosis. Although targeted therapies have demonstrated efficacy in BRAF -mutant colorectal cancer, their role in IHCC remains unclear. Herein, we report the case of a 59-year-old woman with advanced BRAF V600E-mutated IHCC (cT3N3M1c, stage IVc) who was treated with encorafenib, binimetinib, and cetuximab. The BRAF V600E mutation was identified using next-generation sequencing. The patient initially received gemcitabine, cisplatin, and durvalumab as first-line chemotherapy; however, the metastatic lesions progressed rapidly within 1 month. Given the lack of response, second-line treatments with encorafenib, binimetinib, and cetuximab were initiated, leading to a favorable initial response. However, her disease progressed 5 months after initiating second-line treatment. This case highlights the potential benefits of BRAF/MEK/EGFR inhibition in BRAF V600E-mutated IHCC and the need for further research to improve treatment strategies for BRAF V600E-mutated IHCC.