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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.
URL
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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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
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