You may have heard from your doctor that your tumor has a BRAF mutation (pronounced “bee-raff”). What does that mean, and how will this mutation affect your treatment options? Read on to find out what BRAF content CTU has to offer.
It’s important to note that there are many possible BRAF mutations. The most common mutation is BRAF V600E, and this section focuses on BRAF V600E mutated microsatellite stable (MSS) colorectal cancer.
Having a mutation like V600E is a topic of a lot of research. It’s important to be aware of options beyond standard-of-care treatment. BRAF can be aggressive, but supplemeting standard-of-care with targeted treatments and trials can change the course of your disease. Our goal here is to inform you about everything that is available.
The basics
DocTalk
This video is a great overview of treatment options for BRAF.
Treatment regimens
Some common treatment regimens for BRAF-mutated CRC (described in the DocTalk above) include FOLFOX/CAPOX and FOLFOXIRI/FOLFIRINOX. A common next-line treatment for BRAF-targeted treatment is called the BEACON Doublet, which includes BRAF inhibitor encorafenib (Braftovi) and EGFR inhibitor cetuximab (Erbitux). These may be coupled with additional treatments.
Click on the links below to read more about specific treatment regimens.
Treatment questions
Now that you’ve read about common chemo and targeted therapies, it’s good to learn about treatment sequencing. The links below are useful for those interested in knowing what to expect with chemotherapy and what’s next when someone progresses on their current regimen.
For BRAF patients, it’s very important to look at trial options before you need them. For example, there are clinical trials for stage IV patients in the first line setting — which means you have to start these trials before starting chemotherapy. Read about clinical trials below to learn how clinical trials can fit into your treatment plan.
Because BRAF-mutated CRC is a rare subtype, it’s a good idea to make sure that someone in your care team has experience treating your cancer. That could be your primary oncologist, or a specialist to consult with at key decision points. To learn more about your healthcare team, read our link below.
More DocTalks
The Lecture Hall is a great place to learn more about BRAF-mutated colorectal cancer. Watch the videos below to get a good overview of BRAF options.
Playlist
BRAF V600E research update: Dr. Corocan
In this talk, Dr. Ryan Corcoran from MGH talks about the evolution of treatments for BRAF-mutated CRC.
Targeted therapies and immunotherapy: Dr. Morris
Dr. Van Morris from MD Anderson Cancer Center talks about what sort of research is going on and what strategies are being developed for this subtype.
This work is now continuing as a currently enrolling Phase II trial which is very promising, so make sure to take your time to watch this talk. This talk is especially important for people considering enrolling in SWOG 2107 trial.
Tackling targeted therapy refractory BRAF V600E mCRC: Dr. Kopetz
Dr. Kopetz from MD Anderson talks about methods to counter therapy resistance and trials looking at such strategies are covered.
HERKULES-3 trial for BRAF and RAS: Dr. Lee
Dr. Lee from MD Anderson talks about a specific clinical trial called HERKULES where a novel targeted therapy combination is employed.
Patient perspective by Roger
Diagnosed: May 2021
Stage: IV, currently NED
Type: Mucinous adenocarcinoma, MSS, BRAF V600E, IDH1
What advice do you have for other BRAF patients and caregivers?
Do your research. Learn as much as possible about your situation. Use COLONTOWN University.
Plan ahead. There is often a window of opportunity for CRS/HIPEC. If so, you don’t want to miss it. Find out what the risks of waiting versus the risks of doing surgery are. There is a potential trade-off because of potential growth while healing from surgery.
Figure out your priorities. Is three to six months worth more than the small possibility of a cure, even if very unlikely? My philosophy was to fight for surgery, considering that to be the only real curative path.
What are some dos and Don’ts you want people to keep in mind?
Do share more rather than less with your doctors. Things could be relevant.
Do your research. Learn as much as you can about your situation. Use COLONTOWN University.
Do contact experts. Get second opinions. Get third opinions.
Don’t hold back. Ask a lot of questions.
Don’t give up. We applied for CRS/HIPEC once and got rejected. We applied again when I had better response from the Beacon regimen, and got approved.
Important trial to consider for newly-diagnosed metastatic CRC patients
This is a first-line trial, which means that you are ineligible if you have already started chemotherapy. Make sure to discuss your clinical trial options with your doctor after diagnosis.
NCT Number: 04607421
Want to learn more about BRAF?
This article by Cancer Treatment Reviews goes over a European Expert panel consensus on metastatic BRAF-mutated CRC. It includes four sample patient scenarios, and they go through treatment sequences for each patient. It also has a list of current BRAF trials.
Want to chat with other BRAF patients?
Join one of our COLONTOWN Facebook groups:
- Try Tom & Con’s BRAF+ Clinic for BRAF education and community
Want to be part of our community? Fill out the registration form here.