Encorafenib, cetuximab, and cytotoxic chemotherapy combinations in BRAFV600E CRC murine models.

Authors

null

Melanie Nicole Woods

University of Texas MD Anderson Cancer Center, Houston, TX

Melanie Nicole Woods , Vincenzo De Falco , Claudia Prisco , Giulia Martini , Luigi Pio Guerrera , Valentina Belli , Teresa Troiani , Van K. Morris II, John Paul Y.C. Shen , Hey Min Lee , Oscar Villarreal , Alexey Sorokin , Preeti Kanikarla Marie , Fortunato Ciardiello , Scott Kopetz , Stefania Napolitano

Organizations

University of Texas MD Anderson Cancer Center, Houston, TX, University Della Campania Luigi Vanvitelli, Naples, Italy, Department of Experimental Medicine, Universita degil Studi della Campania "Luigi Vanvitelli", Naples, Italy, Medical Oncology, Second University of Naples, Naples, Italy, Medical Oncology, Department of Precision Medicine, Universita degli Studi della Campania, Naples, Italy, University of Campania luigi Vanvitelli, Naples, Italy, Medical Oncology Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy, The University of Texas MD Anderson Cancer Center, Houston, TX, UCSD Moores Cancer Center, La Jolla, CA, Università degli studi della Campania L. Vanvitelli, Caserta, Italy

Research Funding

U.S. National Institutes of Health

Background: Based on promising results from latest trials, a crucial point is to evaluate whether encorafenib (E) plus cetuximab (C), alone or in combination with chemotherapy, can improve clinical outcomes relative to current standard of care in previously untreated BRAFV600E mutant mCRC. Considering the high number of BRAFV600E mutant mCRC patients who will never receive a second-line treatment, the rationale of this strategy is to maximize treatment outcome within the first-line setting. Methods: We performed an in vivo study using human BRAFV600E CRC cell line-derived xenografts in nude mice. We evaluated the efficacy of encorafenib (E) + cetuximab (C), FOLFOX, and FOLFIRI, both as individual regimens and in combinations. Mice were treated for 3 weeks and followed for an additional 8 weeks to evaluate durability of tumor control. Additionally, we validated our findings using 3 BRAFV600E mutated patient derived xenografts. Tumors progressing on single agent and combined treatment were profiled by RNA sequencing, protein extraction for RPPA/Western blot, and establishment of in vitro primary cell cultures for further analyses. Results: Our study showed across all 4 models both FOLFOX and FOLFIRI, each in combination with encorafenib plus cetuximab, having greater efficacy than encorafenib plus cetuximab or either chemotherapy alone. No significant change in toxicity was seen with the addition of chemotherapy. Interestingly, in the one model with long term treatment, FOLFOX + E +/- C performed greatest over the long-term, with significant endpoint separation against all other treatment arms (P < 0.05). Conclusions: Taken together, results from our study suggest that the addition of chemotherapy to BRAF+EGFR targeted therapy can further increase the magnitude of response in BRAFV600E mCRC and is a promising combination now being explored clinically. Additionally, this research will substantially contribute to our understanding of the genetic and molecular bases of resistance to target therapies and chemo-based approach in BRAFV600Econtext.

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Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

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

Track

Colorectal Cancer,Anal Cancer

Sub Track

Translational Research

DOI

10.1200/JCO.2022.40.4_suppl.145

Abstract #

145

Poster Bd #

K9

Abstract Disclosures

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