What is the role of the anti-angiogenic therapy in BRAF (V600E) mutant metastatic colorectal cancer patients in a real-world setting?

Authors

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Nieves Martinez Lago

Medical Oncology Deparment - University Hospital A Coruña, A Coruña, Spain

Nieves Martinez Lago , Marta Covela Rúa , Elena Brozos Vazquez , Ana Fernandez Fernandez Montes , Juan Cruz De La Camara Gomez , Carlos Méndez Méndez , Mónica Jorge Fernández , Antia Cousillas Castiñeira , Begoña Graña Suárez , Guillermo Alfonso Quintero Aldana , Sonia Candamio Folgar , Mercedes Salgado Fernandez , Maria Luz Pellon Augusto , Paula Gonzalez Villarroel , Elena Gallardo Martin , Marta Carmona Campos , Francisca Vazquez Rivera , Carlos Grande Ventura , Alberto Carral Maseda , Margarita Reboredo Lopez

Organizations

Medical Oncology Deparment - University Hospital A Coruña, A Coruña, Spain, Hospital Universitario Lucus Augusti, Lugo, Spain, Complexo Hospitalario Universitario de Santiago, Santiago, Spain, Complejo Hospitalario Universitario Ourense, Ourense, Spain, Complejo Hospitalario de Ferrol, Ferrol, Spain, Centro Oncológico de Galicia, A Coruña, Spain, Hospital Álvaro Cunqueiro, Vigo, Spain, Complejo Hospitalario de Pontevedra, Pontevedra, Spain, Complexo Hospitalario Universitario A Coruña, Galicia, Spain, Complexo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain, Complejo Hospitalario Universitario Ourense, Orense, Spain, Complejo Hospitalario Universitario de Ferrol, La Coruña, Spain, Hospital Alvaro Cunqueiro, Vigo, Spain, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain, Medical Oncology Department - University Hospital A Coruña, A Coruña, Spain

Research Funding

Other

Background: Activating B-type Raf kinase (BRAF) mutations, mostly missense V600E, occur in approximately 8% to 12% of patients with metastatic colorectal cancer (mCRC). BRAF (V600E)mt is a strong predictor of a poor prognosis, with distinct clinical and pathological features. However, it is unknown whether this mutation is predictive of any treatment benefit in a real world setting. Methods: We conducted an observational, retrospective, multicentric study of patients with BRAF V600E-mt mCRC treated at nine university Spanish hospitals in NW Spain, belonging to GITuD (Galician Research Group on Digestive Tumors). Demographic, clinic and pathological characteristics, overall survival (OS) and first-line progression free survival (PFS) were retrospectively collected and analyzed. Results: Data from 65 patients treated between November 2010 to June 2018 were recorded in this study. Median age was 62.8 years (range 30-83 years), 55.4 % female, 75.4% ECOG PS0-1, 49.2% right-sided, 35.2% high grade, 69.2% synchronous presentation, 66.2% primary tumor resection and median metastatic locations was 2 (range 1-5). With a median follow up of 64.6 months, median OS was 12.9 months (95% CI, 9.8-16.0 months) and first line PFS was 4.1 months (95% CI, 2.7-5.5 months). First line PFS according treatment: Bev+Triplet-CT/Bev+Doublet-CT/antiEGFR+Doublet-CT/Doublet-CT: 6.2 vs 4.8 vs 2.9 vs 2.1 months (p = 0.020). Bevacizumab based chemotherapy was associated with a prolonged first line PFS (median 5.0 vs. 2.1 months, HR, 0.406; 95% CI, 0.20-0.81; p = 0.005). Nevertheless, no statistical differences between bevacizumab based regimes, (Triplet-CT vs Doublet-CT (HR 0.830; 95% CI 0.4-1.9; p = 0.666)) or between Doublet-CT with or without a antiEGFR were found (HR 0.511; 95% CI 0.2-1.6; p = 0.223). Conclusions: Our study confirms the negative prognostic impact of BRAF V600Emt in mCRC and encourage the use of anti-angiogenic based chemotherapy in this subgroup of patients.

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Abstract Details

Meeting

2019 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 37, 2019 (suppl 4; abstr 620)

DOI

10.1200/JCO.2019.37.4_suppl.620

Abstract #

620

Poster Bd #

K5

Abstract Disclosures