Clinical and survival characteristics of patients with BRAF-mutated metastatic colorectal cancer (mCRC) who receive metastases surgery in a Spanish cohort.

Authors

null

Javier Soto Sr.

Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain;

Javier Soto Sr., Marianela Bringas Sr., Natalia Gutiérrez Alonso , Andrés J. Muñoz Martín Sr., Aitana Calvo Ferrándiz , Gabriela Torres Pérez-Solero , Laura Ortega , Rocío Martín Lozano , Roberto Jiménez Rodríguez , Irene Gonzalez Caraballo , Carlos López Jiménez , Ana Gutierrez Ortiz de la Tabla , David Salomon Juliao Caamaño , Marc Ariant Cañete Muñoz , Mónica Benavente de Lucas , María Palma Gómez , Manuel Alva Bianchi Sr., Miguel Martin , Pilar Garcia-Alfonso , Íñigo Martínez Delfrade

Organizations

Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; , Hospital General Universitario Gregorio Marañón, Madrid, Spain; , Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain; , Oncología Medica Hospital Gregorio Marañón, Madrid, Spain; , Servicio Oncología Médica, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain; , Servicio Oncología Médica. Hospital General Universitario Gregorio Marañón. IiSGM. Universidad Complutense, Madrid, Spain; , HGUGM, Madrid, Spain; , Gregorio Marañón University General Hospital, Madrid, Spain; , Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain; , Instituto De Investigacion Sanitaria Gregorio Maranon, Madrid, Spain; , Hospital Gregorio Maranon, Madrid, Spain; , Hospital Universitario Ramón y Cajal, Madrid, Spain;

Research Funding

No funding received
None.

Background: Patients with mCRC harboring BRAF mutation have worse prognosis and poor outcomes. However, those who have resectable metastatic disease and undergo surgery may have better outcomes compared to those who do not. Differences in clinical characteristics are not well known and may be critical to identify patients with better prognosis. Methods: We performed a retrospective analysis of 299 patients with mCRC in a tumor registry from 2015 to 2021. We compared the clinical characteristics and survival trends of both cohorts (BRAF mutated and BRAF wild type). Furthermore, we analyzed clinical and survival features of 23 patients with BRAF mutated mCRC who received metastases resection. Results: We identified 34 patients with BRAF mutation (11.37%). Several characteristics were significantly more frequent in this group: age <65 years (n = 24, OR 1.38, p = 0.03), female sex (n = 24, OR 1.74, p = 0.008), primary tumor in the right colon (n = 15, OR 1.93, p = 0.003), peritoneal carcinomatosis (n = 18, OR 2.29, p = 0.007) and increased CA19.9 levels at diagnosis (n = 18, OR 1.79, p = 0.003). They received more peritoneal surgery (n = 12, OR 4.27, p = 0.000) and less liver metastases resection (n = 7, OR 0.51, p = 0.011). Median PFS in the first line of treatment was shorter in patients with BRAF mutation (9.5 vs 12.6 months; HR 1.69; IC 95%: 1.16 – 2.45; p = 0.006); however, we did not found differences in OS. Within the 23 patients with BRAF mutated mCRC who underwent surgery (67,64%), we found significant differences compared with those without metastases surgery: primary tumor resection (n = 21, OR 2.51, p = 0.0017) and having a single metastatic location (n = 18, OR 2.04, p = 0.01). Other features were more frequent in patients who underwent surgery but did not reach statistical significance: right colon location (63.6% vs 37.5%), metachronic disease (47.8% vs 18.2%), normal CEA (50% vs 25%) and CA19.9 (45% vs 12%) at diagnosis, and receiving 3 or more lines of systemic treatment (57% vs 22%). Median PFS after metastasectomy was 14.9 months, but we found no differences between both groups. Conclusions: In our cohort, BRAF mutated mCRC patients were more frequently younger, women, had right-sided primary tumors, higher rates of peritoneal metastases and abnormal CA19.9 levels at diagnosis, including worse outcomes in terms of PFS. On the other hand, resection of the primary tumor and single metastatic location were associated with higher probability of having metastases surgery, although in this study no subsequent survival benefit was found, probably due to the small number of BRAF mutated patients analyzed.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2023 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

Patient-Reported Outcomes and Real-World Evidence

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 66)

DOI

10.1200/JCO.2023.41.4_suppl.66

Abstract #

66

Poster Bd #

D3

Abstract Disclosures

Similar Abstracts

First Author: Laura Ortega

First Author: Bozena Cybulska-Stopa

First Author: Takeshi Yamada