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Gene | BRAF |
Variant | D594G |
Impact List | missense |
Protein Effect | loss of function - predicted |
Gene Variant Descriptions | BRAF D594G lies within the protein kinase domain of the Braf protein (UniProt.org). D594G demonstrates increased transforming ability in one of two cell lines in culture (PMID: 29533785), however, results in impaired Braf kinase activity, but leads to increased activation of Erk signaling through Craf in cell culture (PMID: 18794803, PMID: 28783719), and also demonstrates Craf activation similar to wild-type Braf, but with enhanced dimerization and the ability to bypass autoinhibitory autophosphorylation in in vitro assays (PMID: 31929109), and confers Mek inhibitor resistance in culture (PMID: 18794803), and therefore, is predicted to lead to a loss of Braf protein function. |
Associated Drug Resistance | Y |
Category Variants Paths |
BRAF mutant BRAF D594X BRAF D594G BRAF mutant BRAF inact mut BRAF D594G |
Transcript | NM_004333.6 |
gDNA | chr7:g.140753354T>C |
cDNA | c.1781A>G |
Protein | p.D594G |
Source Database | RefSeq |
Genome Build | GRCh38/hg38 |
Transcript | gDNA | cDNA | Protein | Source Database | Genome Build |
---|---|---|---|---|---|
NM_004333.6 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
NM_001354609.2 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
NM_004333.5 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
NM_001378474.1 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
XM_005250045 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
NM_001378468.1 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
NM_004333 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
NM_001354609.1 | chr7:g.140753354T>C | c.1781A>G | p.D594G | RefSeq | GRCh38/hg38 |
Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
---|---|---|---|---|---|---|---|
BRAF D594G | melanoma | sensitive | Trametinib | Preclinical - Cell culture | Actionable | In a preclinical study, Mekinist (trametinib) reduced ERK signaling and inhibited proliferation of a melanoma cell line harboring BRAF D594G in culture (PMID: 28783719). | 28783719 |
BRAF D594G | gastrointestinal system cancer | no benefit | Trametinib | Case Reports/Case Series | Actionable | In a Phase II trial (NCI-MATCH), Mekinist (trametinib) treatment did not demonstrate clinical activity in patients with advanced solid tumors or lymphoma harboring BRAF fusion or non-V600 mutations, resulted in progressive disease in 4 patients with gastrointestinal system cancer harboring BRAF D594G (PMID: 31924734; NCT02465060). | 31924734 |
BRAF D594G | lung adenocarcinoma | no benefit | Trametinib | Case Reports/Case Series | Actionable | In a clinical case study, a lung adenocarcinoma patient harboring BRAF D594G and TP53 H193L demonstrated stable disease for two months when treated with Mekinist (trametinib), but progressed after four months (PMID: 32540409). | 32540409 |
BRAF D594G | lung adenocarcinoma | no benefit | Trametinib | Case Reports/Case Series | Actionable | In a Phase II trial (NCI-MATCH), Mekinist (trametinib) treatment did not demonstrate clinical activity in patients with advanced solid tumors or lymphoma harboring BRAF fusion or non-V600 mutations, resulted in stable disease in a patient with lung adenocarcinoma harboring BRAF D594G (PMID: 31924734; NCT02465060). | 31924734 |
BRAF D594G | prostate cancer | no benefit | Trametinib | Case Reports/Case Series | Actionable | In a Phase II trial (NCI-MATCH), Mekinist (trametinib) treatment did not demonstrate clinical activity in patients with advanced solid tumors or lymphoma harboring BRAF fusion or non-V600 mutations, resulted in stable disease in a patient with prostate cancer harboring BRAF D594G (PMID: 31924734; NCT02465060). | 31924734 |
BRAF D594G | melanoma | sensitive | Sorafenib | Preclinical - Cell line xenograft | Actionable | In a preclinical study, Nexavar (sorafenib) treatment inhibited Erk phosphorylation, reduced growth, and induced mitochondrial depolarization and apoptosis in melanoma cells harboring BRAF D594G in culture, and inhibited tumor growth and induced regression in a cell line xenograft model (PMID: 18794803). | 18794803 |
BRAF D594G | melanoma | predicted - sensitive | Ulixertinib | Case Reports/Case Series | Actionable | In a clinical case study, Ulixertinib (BVD-523) treatment resulted in a histologic response allowing for surgical resection in a patient with metastatic melanoma harboring BRAF D594G (PMID: 35551160; NCT04566393). | 35551160 |
BRAF D594G | ampulla of Vater cancer | predicted - sensitive | Binimetinib + Encorafenib | Case Reports/Case Series | Actionable | In a Phase II trial (BEAVER), combination treatment with Mektovi (binimetinib) and Braftovi (encorafenib) led to a confirmed partial response in an ampullary cancer patient harboring BRAF D594G, who remained on treatment for at least 5.4 months (Annals of Oncology 32 (2021): S596; NCT03839342). | detail... |
BRAF D594G | colorectal cancer | not predictive | Cetuximab + Irinotecan | Case Reports/Case Series | Actionable | In a clinical study, the combination of Erbitux (cetuximab) with Camptosar (irinotecan) as a third-line therapy resulted in stable disease in two patients with metastatic colorectal cancer harboring BRAF D594G, with progression-free survival of 2.2 and 6.6 months (PMID: 31515458). | 31515458 |
BRAF D594G | colorectal cancer | not predictive | Fluorouracil + Leucovorin + Oxaliplatin + Panitumumab | Case Reports/Case Series | Actionable | In a clinical study, the combination of Vectibix (panitumumab) with FOLFOX as a first-line therapy resulted in two partial responses with progression-free survival of 8.3 and 2.8 months and stable disease with progression-free survival of 7.0 months in patients with metastatic colorectal cancer harboring BRAF D594G (PMID: 31515458). | 31515458 |
BRAF D594G | colorectal cancer | not predictive | Cetuximab + Fluorouracil + Irinotecan + Leucovorin | Case Reports/Case Series | Actionable | In a clinical study, the combination of Erbitux (cetuximab) with FOLFIRI resulted in one partial response with progression-free survival (PFS) of 3.2 months, and two with stable disease with PFS of 3.7 and 3.6 months in patients with metastatic colorectal cancer harboring BRAF D594G who had been previously treated with two lines of therapy (PMID: 31515458). | 31515458 |
BRAF D594G | melanoma | resistant | U0126 | Preclinical - Cell culture | Actionable | In a preclinical study, melanoma cells harboring BRAF D594G demonstrated resistance to U0126 treatment in culture (PMID: 18794803). | 18794803 |
BRAF D594G | colorectal cancer | not predictive | Irinotecan + Panitumumab | Case Reports/Case Series | Actionable | In a clinical study, the combination of Vectibix (panitumumab) with Camptosar (irinotecan) as a third-line therapy resulted in one patient with a partial response with 6.7 months progression-free survival (PFS) and two with stable disease with PFS of 1.8 and 2.3 months in patients with metastatic colorectal cancer harboring BRAF D594G (PMID: 31515458). | 31515458 |
BRAF D594G | colorectal cancer | not predictive | Fluorouracil + Irinotecan + Leucovorin + Panitumumab | Case Reports/Case Series | Actionable | In a clinical study, the combination of Vectibix (panitumumab) with FOLFIRI as a third-line therapy resulted in stable disease with progression-free survival of 2.6 months in a patient with metastatic colorectal cancer harboring BRAF D594G (PMID: 31515458). | 31515458 |
BRAF D594G | mucosal melanoma | predicted - sensitive | Belvarafenib | Case Reports/Case Series | Actionable | In a clinical case study, Belvarafenib (HM95573) treatment resulted in a partial response ongoing at 8.5 months in a mucosal melanoma patient harboring BRAF D594G (PMID: 38470950). | 38470950 |
BRAF D594G | melanoma | sensitive | SIJ777 | Preclinical - Cell culture | Actionable | In a preclinical study, SIJ777 inhibited Mek, Erk, and Akt phosphorylation, proliferation, migration, and invasion, and induced apoptosis in a melanoma cell line harboring BRAF D594G in culture (PMID: 33917428). | 33917428 |