Real-world evaluation of treatment patterns and clinical outcomes in patients with BRAF-V600E metastatic colorectal cancer (mCRC) in Canada

Q3 Medicine

Cancer treatment and research communications Pub Date : 2025-01-01 DOI:10.1016/j.ctarc.2025.100896

William J Phillips , Horia Marginean , Mohammad Alrehaili , Arwa Ahmed Abdelrahim , Tim Asmis , Mike Vickers , Benjamin Yeung , Bryan Lo , Rachel Goodwin

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引用次数: 0

Abstract

Background

BRAF V600E mutations are identified in 10 % of metastatic colorectal cancer (mCRC) cases. In this project, we evaluated the clinicopathologic features and natural history of patients with BRAF mutant (BRAF-mt) mCRC prior to era of BRAF targeted therapy.

Methods

This is a retrospective project evaluating patients with diagnosed with mCRC with an identified BRAF V600E mutation between January 1, 2015 and December 31, 2021 seen at the Ottawa Hospital Cancer Centre prior to the approval of cetuximab and encorafenib in Canada. Demographic, clinical, and cancer characteristics were collected from the medical records. Outcomes of interest included overall survival (OS) and time to next therapy (TNT).

Results

71 patients were included. The median age was 69 years, 37 (52 %) patients were females, and 19 (27 %) were mismatch repair deficient (dMMR). Median OS was 12.9 months with 21 (30 %) patients living greater than 2-years. Signet ring histology (HR=7.27, p < 0.001), peritoneal metastasis (HR=2.29, 0.003), distant lymphatic metastasis (HR=2.70, p < 0.001), brain metastasis (HR=2.86, p < 0.048) and metastatectomy (HR=0.17, p < 0.001) were associated with OS. Forty-six (65 %) patients received first-line systemic therapy, 14 (20 %) second-line and 2 (3 %) third-line. Median duration of therapy was 8.5 months for first-line, 5.5 months for second-line and 1.5 months for third-line.

Conclusion

Real world data demonstrates that patients with BRAF-V600E mCRC have poor clinical outcomes with traditional systemic therapies. Only a minority of patients received second- or third-line systemic treatments, highlighting the importance of ongoing research evaluating incorporation of targeted therapy in first-line treatment.

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背景在10%的转移性结直肠癌（mCRC）病例中发现了BRAF V600E突变。方法这是一个回顾性项目，评估了在加拿大批准西妥昔单抗和安戈非尼之前，2015 年 1 月 1 日至 2021 年 12 月 31 日期间在渥太华医院癌症中心就诊的确诊为 BRAF V600E 突变的 mCRC 患者的临床病理特征和自然病史。我们从病历中收集了患者的人口统计学特征、临床特征和癌症特征。研究结果包括总生存期（OS）和下一次治疗时间（TNT）。中位年龄为69岁，37名（52%）患者为女性，19名（27%）患者存在错配修复缺陷（dMMR）。中位生存期为12.9个月，其中21人（30%）的生存期超过2年。标志环组织学（HR=7.27，p <0.001）、腹膜转移（HR=2.29，0.003）、远处淋巴转移（HR=2.70，p <0.001）、脑转移（HR=2.86，p <0.048）和转移灶切除（HR=0.17，p <0.001）与OS相关。46例（65%）患者接受了一线系统治疗，14例（20%）接受了二线治疗，2例（3%）接受了三线治疗。中位治疗时间为：一线 8.5 个月，二线 5.5 个月，三线 1.5 个月。只有少数患者接受了二线或三线系统治疗，这凸显了当前研究评估将靶向治疗纳入一线治疗的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.