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Ref Type | Journal Article | ||||||||||||
PMID | (25673558) | ||||||||||||
Authors | Pietrantonio F, Petrelli F, Coinu A, Di Bartolomeo M, Borgonovo K, Maggi C, Cabiddu M, Iacovelli R, Bossi I, Lonati V, Ghilardi M, de Braud F, Barni S | ||||||||||||
Title | Predictive role of BRAF mutations in patients with advanced colorectal cancer receiving cetuximab and panitumumab: a meta-analysis. | ||||||||||||
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Abstract Text | Wild type RAS (RAS-wt) status is predictive of the activities of the anti-epidermal growth factor receptor (EGFR) monoclonal antibodies cetuximab (C) and panitumumab (P). We examined the impact of C and P on progression-free survival (PFS), overall survival (OS) and overall response rate (ORR) in advanced colorectal cancer (CRC) patients who have RAS-wt/BRAF-mutant (BRAF-mut) status.Randomised trials that compared C or P plus chemotherapy (or C or P monotherapy) with standard therapy or best supportive care (BSC) were included. We used published hazard ratios (HRs) if they were available, or we derived treatment estimates from other survival data. Pooled estimates of the treatment efficacy of anti-EGFR-based therapy with C or P for the RAS-wt/BRAF-mut subgroup were calculated with the random-effect inverse variance weighted method. All statistical tests were two-sided.Nine phase III trials and one phase II trial (six first-line and two second-line trials, plus two trials involving chemorefractory patients), that included 463 RAS-wt/BRAF-mut CRC patients, were analysed. Overall, the addition of C or P treatment in the BRAF-mut subgroup did not significantly improve PFS (HR, 0.88; 95% confidence interval (CI), 0.67-1.14; p=0.33), OS (HR, 0.91; 95% CI, 0.62-1.34; p=0.63) and ORR (relative risk, 1.31; 95% CI 0.83-2.08, p=0.25) compared with control regimens.C- or P-based therapy did not increase the benefit of standard therapy or the BSC in RAS-wt/BRAF-mut CRC patients. These findings support BRAF mutation assessment before initiation of treatment with anti-EGFR monoclonal antibodies. |
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Therapy Name | Drugs | Efficacy Evidence | Clinical Trials |
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Gene | Variant | Impact | Protein Effect | Variant Description | Associated with drug Resistance |
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Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
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BRAF V600E | colorectal cancer | resistant | Cetuximab | Clinical Study - Meta-analysis | Actionable | In a meta-analysis, the addition of Erbitux (cetuximab) or Vectibix (panitumumab) to standard of care treatment with chemotherapy did not result in improved progression-free survival (HR=0.88; 95% CI, 0.67-1.14; p=0.33), overall survival (HR=0.91; 95% CI, 0.62-1.34; p=0.63), or objective response rate (relative risk=1.31; 95% CI, 0.83-2.08; p=0.25) in patients with advanced colorectal cancer harboring BRAF V600E (PMID: 25673558). | 25673558 |
BRAF V600E | colorectal cancer | resistant | Panitumumab | Clinical Study - Meta-analysis | Actionable | In a meta-analysis, the addition of Erbitux (cetuximab) or Vectibix (panitumumab) to standard of care treatment with chemotherapy did not result in improved progression-free survival (HR=0.88; 95% CI, 0.67-1.14; p=0.33), overall survival (HR=0.91; 95% CI, 0.62-1.34; p=0.63), or objective response rate (relative risk=1.31; 95% CI, 0.83-2.08; p=0.25) in patients with advanced colorectal cancer harboring BRAF V600E (PMID: 25673558). | 25673558 |