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Magnetic resonance imaging (MRI) scan (FLAIR sequence) at the time of diagnosis (A); at completion of 70 weeks of vinblastine (B); 3 months later, before starting dabrafenib (C); at the time of progression, before starting thioguanine, procarbazine, lomustine, and vincristine (TPCV) (D); 6 months after initiation of TPCV (E); 18 months after completion of TPCV (F) Our experience is intriguing and provides some evidence that salvage chemotherapy is still an option when targeted therapy fails. As most BRAF V600E PLGG recur rapidly after cessation of targeted therapies, 3,4 the sustained tumor control 2 years after completion of chemotherapy is encouraging, suggesting a different and potentially synergistic role for chemotherapy in such situations. Further studies will determine whether a combination of targeted and chemotherapy regimens are superior to each of these as a single modality.

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