Real-world evaluation of treatment patterns and clinical outcomes in patients with BRAF-V600E metastatic colorectal cancer (mCRC) in Canada.
| Title: | Real-world evaluation of treatment patterns and clinical outcomes in patients with BRAF-V600E metastatic colorectal cancer (mCRC) in Canada. |
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| Authors: | Phillips WJ; Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.; Marginean H; The Ottawa Hospital Research Institute, Ottawa, ON, Canada.; Alrehaili M; Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.; Abdelrahim AA; Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.; Asmis T; Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada.; Vickers M; Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada.; Yeung B; Eastern Ontario Regional Laboratory Association (EORLA), ON, Canada.; Lo B; The Ottawa Hospital Research Institute, Ottawa, ON, Canada; Eastern Ontario Regional Laboratory Association (EORLA), ON, Canada.; Goodwin R; Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada. Electronic address: rgoodwin@toh.ca. |
| Source: | Cancer treatment and research communications [Cancer Treat Res Commun] 2025; Vol. 43, pp. 100896. Date of Electronic Publication: 2025 Mar 12. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: England NLM ID: 101694651 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-2942 (Electronic) Linking ISSN: 24682942 NLM ISO Abbreviation: Cancer Treat Res Commun Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : Elsevier, [2016]- |
| MeSH Terms: | Colorectal Neoplasms*/genetics ; Colorectal Neoplasms*/pathology ; Colorectal Neoplasms*/mortality ; Colorectal Neoplasms*/drug therapy ; Colorectal Neoplasms*/therapy ; Proto-Oncogene Proteins B-raf*/genetics ; Antineoplastic Combined Chemotherapy Protocols*/therapeutic use; Canada/epidemiology ; Humans ; Female ; Male ; Aged ; Retrospective Studies ; Middle Aged ; Mutation ; Aged, 80 and over ; Neoplasm Metastasis |
| 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.; (Copyright © 2025. Published by Elsevier Ltd.) |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: WJP, MA, HM, AAA, MV, BY have no conflicts to disclose. BL has served on advisory boards for AstraZeneca, Pfizer, Bayer, Novartis, and Roche. He is medical director of a molecular diagnostics lab, which has received research and quality improvement grant support from Amgen, AstraZeneca, Roche, EMD Serono. RG is a member of advisory board for Ipsen, Pfizer, Eisai, Roche, Bayer, AAA and Apobiologix. She has been a speaker for Merck, Viatris, Pfizer and Amgen, as well as received independent educational grants from Pfizer, Eisai, and Apobiologix. TA has served on advisory boards for and received research funding from Novartis and Ipsen. |
| Contributed Indexing: | Keywords: BRAF; Clinical outcomes; Colorectal cancer; Metastatic; Real world |
| Substance Nomenclature: | EC 2.7.11.1 (Proto-Oncogene Proteins B-raf); EC 2.7.11.1 (BRAF protein, human) |
| Entry Date(s): | Date Created: 20250327 Date Completed: 20250523 Latest Revision: 20260715 |
| Update Code: | 20260715 |
| DOI: | 10.1016/j.ctarc.2025.100896 |
| PMID: | 40147102 |
| Database: | MEDLINE |
Journal Article