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BRAF
MUTANT CRC: PARTICULARITIES
•
Small population:
–
8-10% early stage
–
4-5% late stage
•
BRAF V600E mutations as a biomarker?
–
Very poor prognosis in late stage (mCRC)
–
Predictive: negative predictive effect for anti-EGFR MoAbs in some studies:
-
Cetuximab: refractory (European cons.)
1,2
& first-line setting (CRYSTAL study)
3
-
Panitumumab: 2
nd
line setting (PICCOLO study)
4
-
No change in the label by any regulatory authority
•
Non specific approved treatments neither in first line and beyond
–
TRIBE
5
(29 BRAF Mt pts): mOS 19 m; PFS 7’5 m
–
VELOUR
6
(36 BRAF MT pts): mOS 10’3 vs 5’5m; mPFS 5’5 vs 2’2m
1
Di Nicolantonio F, J Clin Oncol 2018;
2
De Roock et al. Lancet Oncol 2010;
3
Van Cutsem et al, J Clin Oncol 2011;
4
Seymour MT
et al, Proc ASCO 2011, Cremolini et al. Lancet Oncol 2015,Wirapati et al. ASCO 2017 Abstr 3538