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Real-world first-line treatment of patients with BRAFV600E-mutant metastatic colorectal cancer: the CAPSTAN CRC study

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dc.contributor.author Martinelli, Erika
dc.contributor.author Cremolini, Chiara
dc.contributor.author Mazard, Thibault
dc.contributor.author Vidal Barrull, Joana
dc.contributor.author Virchow, I.
dc.contributor.author Tougeron, David
dc.contributor.author Cuyle, Pieter-Jan
dc.contributor.author Chibaudel, Benoist
dc.contributor.author Kim, Stefano
dc.contributor.author Ghanem, Ismael
dc.contributor.author Asselain, Bernard
dc.contributor.author Castagné, Coline
dc.contributor.author Zkik, A.
dc.contributor.author Khan, S.
dc.contributor.author Arnold, Dirk
dc.date.accessioned 2023-03-29T06:32:06Z
dc.date.available 2023-03-29T06:32:06Z
dc.date.issued 2022
dc.identifier.citation Martinelli E, Cremolini C, Mazard T, Vidal J, Virchow I, Tougeron D, Cuyle PJ, Chibaudel B, Kim S, Ghanem I, Asselain B, Castagné C, Zkik A, Khan S, Arnold D. Real-world first-line treatment of patients with BRAFV600E-mutant metastatic colorectal cancer: the CAPSTAN CRC study. ESMO Open. 2022 Dec;7(6):100603. DOI: 10.1016/j.esmoop.2022.100603
dc.identifier.issn 2059-7029
dc.identifier.uri http://hdl.handle.net/10230/56368
dc.description.abstract Background: BRAFV600E mutations occur in 8%-12% of metastatic colorectal cancer (mCRC) cases and are associated with poor survival. European guidelines recommend combination (doublet or triplet) chemotherapy plus bevacizumab in first line. However, an unmet need remains for more effective treatments for these patients. Patients and methods: CAPSTAN CRC is a European, retrospective, multicenter, observational study evaluating real-world treatment practices for patients with BRAFV600E-mutant mCRC treated between 1 January 2016 and 31 January 2020. The primary objective was to describe first-line treatment patterns. Secondary objectives included describing baseline demographics, mutational testing procedures, treatment effectiveness, and safety. Results: In total, 255 patients (median age 66.0 years; 58.4% female) with BRAFV600E-mutant unresectable mCRC from seven countries were included. Most had right-sided tumors (52.5%) and presented with synchronous disease at diagnosis (66.4%). Chemotherapy plus targeted therapy (68.7%) was preferred at first line over chemotherapy alone (31.3%). The main first-line treatments were FOLFOX plus bevacizumab (27.1%) and FOLFOXIRI (folinic acid, 5-fluorouracil, oxaliplatin, irinotecan) with/without bevacizumab (27.1%/19.2%). Median duration of first-line treatment was 4.9 months. Overall, 52.5% received second-line treatment. Across all first-line regimens, progression-free survival (PFS) and overall survival were 6.0 [95% confidence interval (CI) 5.3-6.7] months and 12.9 (95% CI 11.6-14.1) months, respectively. Triplet plus targeted therapy was associated with more adverse events (75.0%) compared with triplet chemotherapy alone (50.0%) and doublet chemotherapy alone (36.1%). Multivariate analysis identified low body mass index and presence of three or more metastatic sites as significant prognostic factors for PFS. Conclusions: This study is, to date, the largest real-world analysis of patients with BRAFV600E-mutant mCRC, providing valuable insights into routine first-line treatment practices for these patients. The data highlight the intrinsic aggressiveness of this disease subgroup, confirming results from previous real-world studies and clinical trials, and stressing the urgent need for more effective treatment options in this setting.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof ESMO Open. 2022 Dec;7(6):100603
dc.rights © 2022 The Authors. Published by Elsevier Ltd on behalf of European Society for Medical Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title Real-world first-line treatment of patients with BRAFV600E-mutant metastatic colorectal cancer: the CAPSTAN CRC study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.esmoop.2022.100603
dc.subject.keyword BRAF mutation
dc.subject.keyword Metastatic colorectal cancer
dc.subject.keyword Observational
dc.subject.keyword Real world
dc.subject.keyword Targeted therapy
dc.subject.keyword Treatment practices
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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