{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:13:37Z","timestamp":1788333217068,"version":"build-2803163510"},"reference-count":12,"publisher":"Gobierno de Navarra","issue":"2","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.es"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["An Sist Sanit Navar"],"abstract":"<jats:p>El colangiocarcinoma intrahep\u00e1tico es una neoplasia de mal pron\u00f3stico con opciones terap\u00e9uticas limitadas en estadios avanzados. La identificaci\u00f3n de alteraciones moleculares accionables permite considerar terapias dirigidas en subgrupos seleccionados. \nPresentamos nuestra experiencia cl\u00ednica con un var\u00f3n de 74 a\u00f1os con colangiocarcinoma intrahep\u00e1tico metast\u00e1sico con mutaci\u00f3n BRAF V600E, tratado fuera de indicaci\u00f3n en segunda l\u00ednea con dabrafenib (150 mg\/12 h) y trametinib (2 mg\/24 h) tras progresi\u00f3n a quimioterapia basada en platino. El tratamiento se asoci\u00f3 a enfermedad estable, descenso de CA 19-9 y toxicidad leve, logrando una supervivencia libre de progresi\u00f3n de 12,8 meses y una supervivencia global de 44,4 meses. Este caso refuerza la utilidad de integrar de forma temprana la caracterizaci\u00f3n molecular, as\u00ed como el valor de la terapia dirigida en pr\u00e1ctica cl\u00ednica en tumores de baja supervivencia y con escasas alternativas farmacol\u00f3gicas.<\/jats:p>","DOI":"10.23938\/assn.1159","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:00:21Z","timestamp":1782316821000},"page":"e1159","source":"Crossref","is-referenced-by-count":0,"title":["Tratamiento con dabrafenib y trametinib en un caso de colangiocarcinoma intrahep\u00e1tico con mutaci\u00f3n BRAF V600E","Treatment with dabrafenib and trametinib in an intrahepatic cholangiocarcinoma harboring a BRAF V600E mutation"],"prefix":"10.23938","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2938-1097","authenticated-orcid":false,"given":"Arturo","family":"G\u00e1miz Rejano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5674-045X","authenticated-orcid":false,"given":"Ana Isabel","family":"Gago S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Mar\u00eda","family":"Rodr\u00edguez Alonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10024","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1. BANALES JM, MARIN JJG, LAMARCA A, RODRIGUES PM, KHAN SA, ROBERTS LR et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol 2020;17(9):557-588. https:\/\/doi.org\/10.1038\/s41575-020-0310-z","DOI":"10.1038\/s41575-020-0310-z"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. SHROFF RT, BACHINI M. Treatment options for biliary tract cancer: unmet needs, new targets and opportunities from both physicians' and patients' perspectives. Future Oncol 2024;20(20):1435-1450. https:\/\/doi.org\/10.1080\/14796694.2024.2340959","DOI":"10.1080\/14796694.2024.2340959"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. VALERY M, VASSEUR D, FACHINETTI F, BOIL\u00c8VE A, SMOLENSCHI C, TARABAY A et al. Targetable molecular alterations in the treatment of biliary tract cancers: an overview of available treatments. Cancers (Basel) 2023;15(18):4446. https:\/\/doi.org\/10.3390\/cancers15184446","DOI":"10.3390\/cancers15184446"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. KELLEY RK, UENO M, YOO C, FINN RS, FURUSE J, REN Z et al. Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2023;401(10391):1853-1865. https:\/\/doi.org\/10.1016\/S0140-6736(23)00727-4","DOI":"10.1016\/S0140-6736(23)00727-4"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. NEUZILLET C, DECRAECKER M, LARRUE H, NTANDA-NWANDJI LC, BARBIER L, BARGE S et al. Management of intrahepatic and perihilar cholangiocarcinomas: guidelines of the French Association for the Study of the Liver (AFEF). Liver Int 2024;44(10):2517-2537. https:\/\/doi.org\/10.1111\/liv.15948","DOI":"10.1111\/liv.15948"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. OH DY, HE AR, BOUATTOUR M, OKUSAKA T, QIN S, CHEN LT et al. Durvalumab or placebo plus gemcitabine and cisplatin in advanced biliary tract cancer (TOPAZ-1): updated overall survival from a randomised phase 3 study. Lancet Gastroenterol Hepatol 2024;9(8):694-704. https:\/\/doi.org\/10.1016\/S2468-1253(24)00095-5","DOI":"10.1016\/S2468-1253(24)00095-5"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. VOGEL A, DUCREUX M. ESMO clinical practice guideline interim update on the management of biliary tract cancer. ESMO Open 2025;10(1):104003. https:\/\/doi.org\/10.1016\/j.esmoop.2024.104003","DOI":"10.1016\/j.esmoop.2024.104003"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8. MOSELE F, REMON J, MATEO J, WESTPHALEN CB, BARLESI F, LOLKEMA MP et al. Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO Precision Medicine Working Group.Ann Oncol 2020;31(11):1491-1505. https:\/\/doi.org\/10.1016\/j.annonc.2020.07.014","DOI":"10.1016\/j.annonc.2020.07.014"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. SUBBIAH V, KREITMAN RJ, WAINBERG ZA, GAZZAH A, LASSEN U, STEIN A et al. Dabrafenib plus trametinib in BRAFV600E-mutated rare cancers: the phase 2 ROAR trial. Nature Medicine 2023;29(5):1103-1112. https:\/\/doi.org\/10.1038\/s41591-023-02321-8","DOI":"10.1038\/s41591-023-02321-8"},{"key":"ref9","unstructured":"10. Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios. Centro de Informaci\u00f3n Online de Medicamentos de la AEMPS. Ficha t\u00e9cnica Tafinlar (dabrafenib) 75 mg c\u00e1psulas duras. Consultado el 20 de diciembre de 2025. https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/113865003\/FT_113865003.html"},{"key":"ref10","unstructured":"11. Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios. Centro de Informaci\u00f3n Online de Medicamentos de la AEMPS. Ficha t\u00e9cnica Mekinist (trametinib) 2 mg comprimidos recubiertos. Consultado el 20 de diciembre de 2025. https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/114931006\/FT_114931006.html"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12.SHIMOI T, SUNAMI K, TAHARA M, NISHIWAKI S, TANAKA S, BABA E et al. Dabrafenib and trametinib administration in patients with BRAF V600E\/R or non-V600 BRAF mutated advanced solid tumours (BELIEVE, NCCH1901): a multicentre, open-label, and single-arm phase II trial. 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