BRAF V600E in cholangiocarcinoma (mainly intrahepatic, ~5%) is a tumor-agnostic FDA Level...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-BRAF-V600E-CHOLANGIO |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-CHOLANGIOCARCINOMA |
| Sources | SRC-CIVIC SRC-NCCN-HEPATOBILIARY |
Actionability Facts
| Biomarker | BIO-BRAF-V600E |
|---|---|
| Variant | V600E (exon 15, kinase domain — present in ~5% of intrahepatic cholangiocarcinoma; rarer in extrahepatic) |
| Disease | DIS-CHOLANGIOCARCINOMA |
| ESCAT tier | IA |
| Recommended combinations | dabrafenib + trametinib (2L+ BRAF V600E cholangio per SRC-NCCN-HEPATOBILIARY) |
| Contraindicated monotherapy | BRAF inhibitor monotherapy (paradoxical MAPK activation; combine with MEK inhibitor) |
| Evidence summary | BRAF V600E in cholangiocarcinoma (mainly intrahepatic, ~5%) is a tumor-agnostic FDA Level-1 actionable target. Dabrafenib + trametinib is recommended for previously-treated BRAF V600E cholangiocarcinoma per SRC-NCCN-HEPATOBILIARY based on the ROAR basket trial (Subbiah Lancet Oncol 2020 — biliary tract cohort ORR 51%, mPFS 9 mo, mOS 14 mo). 1L remains gemcitabine + cisplatin ± durvalumab (TOPAZ-1) for most patients; testing for BRAF V600E is recommended at diagnosis to plan 2L+ in patients without other actionable alterations (FGFR2 fusion, IDH1 mutation) per SRC-NCCN-HEPATOBILIARY. |
Notes
ESCAT IA / OncoKB Level 1 (tumor-agnostic). Comprehensive molecular profiling at diagnosis is per-NCCN standard for advanced biliary tract cancers — covers FGFR2 fusion, IDH1 R132, BRAF V600E, HER2, MSI, NTRK fusion. Source-gap: SRC-NCCN-HEPATOBILIARY currently a STUB; SRC-ROAR-SUBBIAH-2020 (biliary cohort) not yet ingested.
Used By
No reverse references found in the YAML corpus.