Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review
Mutation of the BRAF proto-oncogene is found in approximately 10% of colorectal cancers (CRC), with much of the mutation conferred by a V600E mutation. Unlike other CRC subtypes, BRAF-mutant CRC have had relatively limited response to conventional therapies and overall poor survival. We present the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.795381/full |
| _version_ | 1819319667743784960 |
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| author | Su Min Cho Abdullah Esmail Maen Abdelrahim Maen Abdelrahim Maen Abdelrahim |
| author_facet | Su Min Cho Abdullah Esmail Maen Abdelrahim Maen Abdelrahim Maen Abdelrahim |
| author_sort | Su Min Cho |
| collection | DOAJ |
| description | Mutation of the BRAF proto-oncogene is found in approximately 10% of colorectal cancers (CRC), with much of the mutation conferred by a V600E mutation. Unlike other CRC subtypes, BRAF-mutant CRC have had relatively limited response to conventional therapies and overall poor survival. We present the case of a 75-year-old man with severe nonischemic cardiomyopathy on a LifeVest who was found to have a transverse colonic mass with widespread hepatic metastatic disease and was subsequently found to have BRAFV600E-mutant CRC (MSI High/dMMR). After a failed therapy with FOLFOX and pembrolizumab, the patient was started on a regimen of vemurafenib, irinotecan, and cetuximab (VIC) based on the SWOG 1406 trial which had shown improved progression-free survival and response rate for the treatment of BRAFV600E-mutant metastatic CRC. After 40 cycles of VIC, the patient attained complete response and is in remission off chemotherapy with significant improvement. This case highlights the effectiveness of the triple-regimen of vemurafenib, irinotecan, and cetuximab as a treatment option for BRAFV600E-mutant CRC, which is a treatment regimen based on the SWOG 1406 trial, and also demonstrates the synergistic role of BRAFV600E inhibitors and EGFR inhibitors in the treatment of BRAFV600E-mutant CRC. |
| first_indexed | 2024-12-24T11:07:20Z |
| format | Article |
| id | doaj.art-85bd18bc85134647807e68980e382137 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-24T11:07:20Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-85bd18bc85134647807e68980e3821372022-12-21T16:58:36ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-12-011210.3389/fphar.2021.795381795381Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and ReviewSu Min Cho0Abdullah Esmail1Maen Abdelrahim2Maen Abdelrahim3Maen Abdelrahim4Department of Medicine, Houston Methodist Hospital, Houston, TX, United StatesSection of GI Oncology, Department of Medical Oncology, Houston Methodist Cancer Center, Houston, TX, United StatesSection of GI Oncology, Department of Medical Oncology, Houston Methodist Cancer Center, Houston, TX, United StatesCockrell Center of Advanced Therapeutics Phase I Program, Houston Methodist Research Institute, Houston, TX, United StatesWeill Cornell Medical College, New York, NY, United StatesMutation of the BRAF proto-oncogene is found in approximately 10% of colorectal cancers (CRC), with much of the mutation conferred by a V600E mutation. Unlike other CRC subtypes, BRAF-mutant CRC have had relatively limited response to conventional therapies and overall poor survival. We present the case of a 75-year-old man with severe nonischemic cardiomyopathy on a LifeVest who was found to have a transverse colonic mass with widespread hepatic metastatic disease and was subsequently found to have BRAFV600E-mutant CRC (MSI High/dMMR). After a failed therapy with FOLFOX and pembrolizumab, the patient was started on a regimen of vemurafenib, irinotecan, and cetuximab (VIC) based on the SWOG 1406 trial which had shown improved progression-free survival and response rate for the treatment of BRAFV600E-mutant metastatic CRC. After 40 cycles of VIC, the patient attained complete response and is in remission off chemotherapy with significant improvement. This case highlights the effectiveness of the triple-regimen of vemurafenib, irinotecan, and cetuximab as a treatment option for BRAFV600E-mutant CRC, which is a treatment regimen based on the SWOG 1406 trial, and also demonstrates the synergistic role of BRAFV600E inhibitors and EGFR inhibitors in the treatment of BRAFV600E-mutant CRC.https://www.frontiersin.org/articles/10.3389/fphar.2021.795381/fullBRAF, CRCVemurafenibIrinotecan, CetuximabMetastasisSWOGImmunotherapy |
| spellingShingle | Su Min Cho Abdullah Esmail Maen Abdelrahim Maen Abdelrahim Maen Abdelrahim Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review Frontiers in Pharmacology BRAF, CRC Vemurafenib Irinotecan, Cetuximab Metastasis SWOG Immunotherapy |
| title | Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review |
| title_full | Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review |
| title_fullStr | Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review |
| title_full_unstemmed | Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review |
| title_short | Triple-Regimen of Vemurafenib, Irinotecan, and Cetuximab for the Treatment of BRAFV600E-Mutant CRC: A Case Report and Review |
| title_sort | triple regimen of vemurafenib irinotecan and cetuximab for the treatment of brafv600e mutant crc a case report and review |
| topic | BRAF, CRC Vemurafenib Irinotecan, Cetuximab Metastasis SWOG Immunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.795381/full |
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