What is the role of the anti-angiogenic therapy in BRAF (V600E) mutant metastatic colorectal cancer patients in a real-world setting?
2019; Lippincott Williams & Wilkins; Volume: 37; Issue: 4_suppl Linguagem: Inglês
10.1200/jco.2019.37.4_suppl.620
ISSN1527-7755
AutoresNieves Martínez Lago, Marta Covela Rúa, Elena Vázquez, Ana Fernández Montés, Juan Cruz de la Cámara Gómez, Carlos Mendez‐Dorantes, Mónica Jorge Fernández, Antia Cousillas Castiñeira, Begoña Graña, Guillermo Alfonso Quintero Aldana, Sonia Candamio Folgar, Mercedes Salgado Fernández, María Luz Pellón Augusto, Paula González Villarroel, Elena Gallardo Martín, Marta Campos, Francisca Rivera, C. Grande Ventura, Alberto Carral Maseda, Margarita Reboredo López,
Tópico(s)Colorectal Cancer Surgical Treatments
Resumo620 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 V600E mt in mCRC and encourage the use of anti-angiogenic based chemotherapy in this subgroup of patients.
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