Colon cancer, BRAF-mutated

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Ryan Nguyen, DO
University of Illinois at Chicago
Chicago, IL

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Neeta K. Venepalli, MD, MBA
University of Illinois at Chicago
Chicago, IL

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

3 regimens on this page
3 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

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Regimen

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

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Regimen

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

Dabrafenib, Trametinib, Panitumumab

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Regimen

Study Evidence Efficacy
Atreya et al. 2017 (Study 116833) Phase I/II (E) ORR: 26%

Chemotherapy

14-day cycles

References

  1. Abstract: Chloe EA, Van Cutsem E, Bendell JC, Andre T, Schellens JHM, Gordon MS, McRee AJ, O'Dwyer PJ, Muro K, Tabernero J, Van Geel R, Sidhu R, Greger JG, Rangwala FA, Motwani M, Wu Y, Orford KW, and Corcoran RB. Journal of Clinical Oncology 2015 33:15_suppl, 103-103. Published online January 31, 2017. link to abstract