ID: 30M presenting with headaches and new-onset seizure
PMHx: None
Exam: Neurologically intact
Course: MRI reviewed a large frontotemporal enhancing mass suspicious for high grade glioma. Underwent maximal safe resection. Pathology consistent with epithelioid glioblastoma, IDH-wildtype. MGMT promoter methylated. NGS identified a BRAF V600E mutation.
Question: Would you favour standard Stupp chemoradiation and reserve BRAF/MEK inhibition for recurrence, or incorporate targeted therapy upfront in the adjuvant setting? Would you consider concurrent BRAF/MEK inhibition with radiation, or only after completion of radiation?
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Kevin Wang
Princess Margaret Cancer Centre
Toronto ON
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