Difference between revisions of "Colorectal cancer, BRAF-mutated"

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=Advanced or metastatic disease, second or third-line therapy=
 
=Advanced or metastatic disease, second or third-line therapy=
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==Encorafenib, Binimetinib, and Cetuximab {{#subobject:1a2d3b|Regimen=1}}==
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==Binimetinib, Encorafenib, Cetuximab {{#subobject:ea894c|Regimen=1}}==
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{| class="wikitable" style="float:right; margin-left: 5px;"
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|-
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|[[#top|back to top]]
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|}
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===Regimen {{#subobject:9134b2|Variant=1}}===
 
{| class="wikitable" style="width: 100%; text-align:center;"  
 
{| class="wikitable" style="width: 100%; text-align:center;"  
 
!style="width: 25%"|Study
 
!style="width: 25%"|Study
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|-
 
|-
 
|[https://www.nejm.org/doi/full/10.1056/NEJMoa1908075 Kopetz et al. 2019 (BEACON)]
 
|[https://www.nejm.org/doi/full/10.1056/NEJMoa1908075 Kopetz et al. 2019 (BEACON)]
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|style="background-color:#1a9851"|Phase III  
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|style="background-color:#1a9851"|Phase III (E)
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|1. Cetuximab & Irinotecan <br> 2. Cetuximab & FOLFIRI
+
|1. Irinotecan & Cetuximab <br> 2. FOLFIRI & Cetuximab
 
| style="background-color:#91cf60" |Seems to have superior OS
 
| style="background-color:#91cf60" |Seems to have superior OS
 
|-
 
|-
 
|}
 
|}
 
====Chemotherapy====
 
====Chemotherapy====
−
*[[Encorafenib (Braftovi)]] 300 mg PO once per day on days 1 through 28
+
*[[Binimetinib (Mektovi)]] 45 mg PO twice per day
−
*[[Binimetinib (Mektovi)]] 45mg PO twice per day on days 1 through 28
+
*[[Encorafenib (Braftovi)]] 300 mg PO once per day
−
*[[Cetuximab (Erbitux)]] 400 mg/m<sup>2</sup> IV over 120 minutes on day 1
+
*[[Cetuximab (Erbitux)]] as follows:
−
*[[Cetuximab (Erbitux)]] 250 mg/m<sup>2</sup> IV over 60 minutes on days 8, 15, 22
+
**Cycle 1: 400 mg/m<sup>2</sup> IV over 120 minutes once on day 1, then 250 mg/m<sup>2</sup> IV over 60 minutes once per day on days 8, 15, 22
 +
**Cycle 2 onwards: 250 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1, 8, 15, 22
  
−
'''28-day cycle, continued indefinitely'''
+
'''28-day cycles'''
  
 
===References===
 
===References===
−
# '''BEACON:''' Kopetz S, Grothey A, Yaeger R, Van Cutsem E, Desai J, Yoshino T, Wasan H, Ciardiello F, Loupakis F, Hong YS, Steeghs N, Guren TK, Arkenau HT, Garcia-Alfonso P, Pfeiffer P, Orlov S, Lonardi S, Elez E, Kim TW, Schellens JHM, Guo C, Krishnan A, Dekervel J, Morris V, Calvo Ferrandiz A, Tarpgaard LS, Braun M, Gollerkeri A, Keir C, Maharry K, Pickard M, Christy-Bittel J, Anderson L, Sandor V, Tabernero J. Encorafenib, Binimetinib, and Cetuximab in BRAF V600E–Mutated Colorectal Cancer. N Engl J Med. 2019 Oct 24;381(17):1632-1643. doi: 10.1056/NEJMoa1908075. Epub 2019 Sep 30. [https://www.nejm.org/doi/full/10.1056/NEJMoa1908075 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/31566309 PubMed]
+
# '''BEACON:''' Kopetz S, Grothey A, Yaeger R, Van Cutsem E, Desai J, Yoshino T, Wasan H, Ciardiello F, Loupakis F, Hong YS, Steeghs N, Guren TK, Arkenau HT, Garcia-Alfonso P, Pfeiffer P, Orlov S, Lonardi S, Elez E, Kim TW, Schellens JHM, Guo C, Krishnan A, Dekervel J, Morris V, Calvo Ferrandiz A, Tarpgaard LS, Braun M, Gollerkeri A, Keir C, Maharry K, Pickard M, Christy-Bittel J, Anderson L, Sandor V, Tabernero J. Encorafenib, Binimetinib, and Cetuximab in BRAF V600E–Mutated Colorectal Cancer. N Engl J Med. 2019 Oct 24;381(17):1632-1643. Epub 2019 Sep 30. [https://www.nejm.org/doi/full/10.1056/NEJMoa1908075 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/31566309 PubMed]
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−
==Vemurafenib, Irinotecan, and Cetuximab {{#subobject:1a2d3b|Regimen=1}}==
 
  
 +
==Irinotecan, Vemurafenib, Cetuximab {{#subobject:aab14c|Regimen=1}}==
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{| class="wikitable" style="float:right; margin-left: 5px;"
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|-
 +
|[[#top|back to top]]
 +
|}
 +
===Regimen {{#subobject:98buya|Variant=1}}===
 
{| class="wikitable" style="width: 100%; text-align:center;"  
 
{| class="wikitable" style="width: 100%; text-align:center;"  
 
!style="width: 25%"|Study
 
!style="width: 25%"|Study
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|-
 
|-
 
|[https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.520 Kopetz et al. 2017 (SWOG 1406)]
 
|[https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.520 Kopetz et al. 2017 (SWOG 1406)]
−
|style="background-color:#1a9851"|Phase II  
+
|style="background-color:#1a9851"|Randomized Phase II (E)
−
| Cetuximab & Irinotecan
+
| Irinotecan & Cetuximab  
 
| style="background-color:#91cf60" |Seems to have superior PFS
 
| style="background-color:#91cf60" |Seems to have superior PFS
 
|-
 
|-
 
|}
 
|}
 
====Chemotherapy====
 
====Chemotherapy====
−
*[[Vemurafenib (Zelboraf)]] 960 mg PO twice per day on days 1 through 14
+
*[[Irinotecan (Camptosar)]] 180 mg/m<sup>2</sup> IV once on day 1
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*[[Irinotecan (Camptosar)]] 180mg/m<sup>2</sup> IV on day 1
+
*[[Vemurafenib (Zelboraf)]] 960 mg PO twice per day
−
*[[Cetuximab (Erbitux)]] 500 mg/m<sup>2</sup> IV on day 1
+
*[[Cetuximab (Erbitux)]] 500 mg/m<sup>2</sup> IV once on day 1
  
−
'''14-day cycle, continued indefinitely'''
+
'''14-day cycles'''
  
 
===References===
 
===References===
−
# '''SWOG 1406:''' Kopetz S, McDonough S, Morris V, Lenz HJ, Magliocco A, Atreya C, Diaz L, Allegra C, Lieu C, Wang S, Eckhardt SG, Semrad T, Kaberle K, Guthrie K, Hochster H. Randomized phase II study of irinotecan and cetuximab with or without vemurafenib in BRAF-mutant metastatic colorectal cancer (SWOG1406). DOI: 10.1200/JCO.2017.35.4_suppl.520 Journal of Clinical Oncology 35, no. 4_suppl (February 01, 2017) 520-520. Published online March 21, 2017.[https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.520 link to original article]  
+
# '''Abstract:''' Kopetz S, McDonough S, Morris V, Lenz HJ, Magliocco A, Atreya C, Diaz L, Allegra C, Lieu C, Wang S, Eckhardt SG, Semrad T, Kaberle K, Guthrie K, Hochster H. Randomized phase II study of irinotecan and cetuximab with or without vemurafenib in BRAF-mutant metastatic colorectal cancer (SWOG1406). Journal of Clinical Oncology 35, no. 4_suppl (February 01, 2017) 520-520. Published online March 21, 2017. [https://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.520 link to abstract]  
  
 
[[Category:Colon cancer regimens]]
 
[[Category:Colon cancer regimens]]
 
[[Category:Biomarker-specific pages]]
 
[[Category:Biomarker-specific pages]]
 
[[Category:Colorectal cancers]]
 
[[Category:Colorectal cancers]]

Revision as of 16:20, 6 November 2019

Section editor
Nkv.jpg
 Neeta K. Venepalli, MD, MBA
University of Illinois at Chicago
Chicago, IL

Note: the page has regimens specific to BRAF-mutated colon cancer.

4 regimens on this page
5 variants on this page


Guidelines

ESMO

Older

Japanese Society for Cancer of the Colon and Rectum

NCCN

SIOG

Advanced or metastatic disease, second or third-line therapy

Binimetinib, Encorafenib, Cetuximab

back to top

Regimen

Study Evidence Comparator Comparative Efficacy
Kopetz et al. 2019 (BEACON) Phase III (E) 1. Irinotecan & Cetuximab
2. FOLFIRI & Cetuximab 		Seems to have superior OS

Chemotherapy

  • Binimetinib (Mektovi) 45 mg PO twice per day
  • Encorafenib (Braftovi) 300 mg PO once per day
  • Cetuximab (Erbitux) as follows:
    • Cycle 1: 400 mg/m2 IV over 120 minutes once on day 1, then 250 mg/m2 IV over 60 minutes once per day on days 8, 15, 22
    • Cycle 2 onwards: 250 mg/m2 IV over 60 minutes once per day on days 1, 8, 15, 22

28-day cycles

References

  1. BEACON: Kopetz S, Grothey A, Yaeger R, Van Cutsem E, Desai J, Yoshino T, Wasan H, Ciardiello F, Loupakis F, Hong YS, Steeghs N, Guren TK, Arkenau HT, Garcia-Alfonso P, Pfeiffer P, Orlov S, Lonardi S, Elez E, Kim TW, Schellens JHM, Guo C, Krishnan A, Dekervel J, Morris V, Calvo Ferrandiz A, Tarpgaard LS, Braun M, Gollerkeri A, Keir C, Maharry K, Pickard M, Christy-Bittel J, Anderson L, Sandor V, Tabernero J. Encorafenib, Binimetinib, and Cetuximab in BRAF V600E–Mutated Colorectal Cancer. N Engl J Med. 2019 Oct 24;381(17):1632-1643. Epub 2019 Sep 30. link to original article contains verified protocol PubMed

Irinotecan, Vemurafenib, Cetuximab

back to top

Regimen

Study Evidence Comparator Comparative Efficacy
Kopetz et al. 2017 (SWOG 1406) Randomized Phase II (E) Irinotecan & Cetuximab Seems to have superior PFS

Chemotherapy

14-day cycles

References

  1. Abstract: Kopetz S, McDonough S, Morris V, Lenz HJ, Magliocco A, Atreya C, Diaz L, Allegra C, Lieu C, Wang S, Eckhardt SG, Semrad T, Kaberle K, Guthrie K, Hochster H. Randomized phase II study of irinotecan and cetuximab with or without vemurafenib in BRAF-mutant metastatic colorectal cancer (SWOG1406). Journal of Clinical Oncology 35, no. 4_suppl (February 01, 2017) 520-520. Published online March 21, 2017. link to abstract
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