What are the second-line treatment options for advanced or metastatic colon cancer that is BRAF V600E mutation positive?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

For advanced or metastatic colon cancer that is BRAF V600E mutation positive, NCCN guidelines include the following as second-line therapy options [93] :

  • Dabrafenib plus trametinib plus either cetuximab or panitumumab 
  • Encorafenib plus either cetuximab or panitumumab, with or without binimetinib

In the open-label, phase 3 BEACON trial, triplet therapy with the BRAF inhibitor encorafenib, the MEK inhibitor binimetinib, and the EGFR inhibitor monoclonal antibody cetuximab provided an overall survival benefit for patients with metastatic colorectal cancer who had the BRAF V600E mutation. The BEACON trial enrolled 665 patients with BRAF V600E–mutated metastatic colorectal cancer who had disease progression after one or two previous regimens. Median overall survival was 9.0 months in the triplet-therapy group, compared with 5.4 months for patients in the control group, who received doublet therapy with encorafenib plus cetuximab, cetuximab plus irinotecan, or cetuximab plus FOLFIRI. [130]


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