Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study

Abstract Background Patients with V-Raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E-mutated advanced colorectal cancer (CRC) have a poor prognosis, and treatment options that can improve outcome are still under investigation. The purpose of this study was to discuss the differences of over...

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Main Authors: Qianhao Meng, Jian Zhao, Yuanyuan Yu, Ke Wang, Jing Ren, Chang Xu, Yusheng Wang, Guangyu Wang
Format: Article
Language:English
Published: BMC 2023-02-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-023-10640-9
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author Qianhao Meng
Jian Zhao
Yuanyuan Yu
Ke Wang
Jing Ren
Chang Xu
Yusheng Wang
Guangyu Wang
author_facet Qianhao Meng
Jian Zhao
Yuanyuan Yu
Ke Wang
Jing Ren
Chang Xu
Yusheng Wang
Guangyu Wang
author_sort Qianhao Meng
collection DOAJ
description Abstract Background Patients with V-Raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E-mutated advanced colorectal cancer (CRC) have a poor prognosis, and treatment options that can improve outcome are still under investigation. The purpose of this study was to discuss the differences of overall survival (OS) and progression-free survival (PFS) between patients with BRAF V600E-mutated advanced CRC who were treated with chemotherapy alone and chemotherapy combined with targeted therapy in advanced first-line therapy. Methods Grouping of 61 patients according to first-line treatment regimen (chemotherapy alone/chemotherapy combined with bevacizumab). Kaplan–Meier method and log-rank test were used to compare OS and PFS. Cox proportional hazards regression model was used to measure the risk of first-line medication therapies while correcting for confounding factors that may affect PFS and OS. Results There was no significant difference in OS between patients treated with chemotherapy alone and those treated with chemotherapy combined with bevacizumab (P = 0.93; HR, 1.027; 95% CI, 0.555–1.901). Likewise, there was no significant difference in PFS between the two groups (P = 0.29; HR, 0.734; 95% CI, 0.413–1.304). Subgroup analysis showed that OS and PFS of different treatment regimens were not significantly different among subgroups. Multivariate analysis suggested that surgical treatment of primary tumor (P = 0.001; HR, 0.326; 95% CI, 0.169–0.631) and presence of liver metastasis (P = 0.009; HR, 2.399; 95% CI, 1.242–4.635) may serve as independent prognostic indicators in patients with BRAF-mutated advanced CRC. Surgical treatment of the primary tumor (P = 0.041; HR, 0.523; 95% CI, 0.280–0.974) was significantly associated with PFS too. Conclusion For patients with BRAF V600E-mutated advanced CRC, chemotherapy alone did not differ significantly in OS and PFS compared with chemotherapy + bevacizumab for advanced first-line therapy. Chemotherapy combined with targeted therapy did not render a survival benefit to these patients, demonstrating that the importance of developing new treatment options for this population.
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spelling doaj.art-bc62d99ffc364229a3e8b64ecb91772f2023-03-22T11:35:08ZengBMCBMC Cancer1471-24072023-02-0123111110.1186/s12885-023-10640-9Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective studyQianhao Meng0Jian Zhao1Yuanyuan Yu2Ke Wang3Jing Ren4Chang Xu5Yusheng Wang6Guangyu Wang7Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer HospitalDepartment of Digestive, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastrointestinal Medical Oncology, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Medical Oncology, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Medical Oncology, Harbin Medical University Cancer HospitalDepartment of Gastrointestinal Medical Oncology, Harbin Medical University Cancer HospitalDepartment of Digestive, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastrointestinal Medical Oncology, Harbin Medical University Cancer HospitalAbstract Background Patients with V-Raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E-mutated advanced colorectal cancer (CRC) have a poor prognosis, and treatment options that can improve outcome are still under investigation. The purpose of this study was to discuss the differences of overall survival (OS) and progression-free survival (PFS) between patients with BRAF V600E-mutated advanced CRC who were treated with chemotherapy alone and chemotherapy combined with targeted therapy in advanced first-line therapy. Methods Grouping of 61 patients according to first-line treatment regimen (chemotherapy alone/chemotherapy combined with bevacizumab). Kaplan–Meier method and log-rank test were used to compare OS and PFS. Cox proportional hazards regression model was used to measure the risk of first-line medication therapies while correcting for confounding factors that may affect PFS and OS. Results There was no significant difference in OS between patients treated with chemotherapy alone and those treated with chemotherapy combined with bevacizumab (P = 0.93; HR, 1.027; 95% CI, 0.555–1.901). Likewise, there was no significant difference in PFS between the two groups (P = 0.29; HR, 0.734; 95% CI, 0.413–1.304). Subgroup analysis showed that OS and PFS of different treatment regimens were not significantly different among subgroups. Multivariate analysis suggested that surgical treatment of primary tumor (P = 0.001; HR, 0.326; 95% CI, 0.169–0.631) and presence of liver metastasis (P = 0.009; HR, 2.399; 95% CI, 1.242–4.635) may serve as independent prognostic indicators in patients with BRAF-mutated advanced CRC. Surgical treatment of the primary tumor (P = 0.041; HR, 0.523; 95% CI, 0.280–0.974) was significantly associated with PFS too. Conclusion For patients with BRAF V600E-mutated advanced CRC, chemotherapy alone did not differ significantly in OS and PFS compared with chemotherapy + bevacizumab for advanced first-line therapy. Chemotherapy combined with targeted therapy did not render a survival benefit to these patients, demonstrating that the importance of developing new treatment options for this population.https://doi.org/10.1186/s12885-023-10640-9Advanced colorectal cancerBRAF V600E mutationOverall survivalProgression-free survival
spellingShingle Qianhao Meng
Jian Zhao
Yuanyuan Yu
Ke Wang
Jing Ren
Chang Xu
Yusheng Wang
Guangyu Wang
Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
BMC Cancer
Advanced colorectal cancer
BRAF V600E mutation
Overall survival
Progression-free survival
title Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
title_full Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
title_fullStr Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
title_full_unstemmed Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
title_short Survival comparison of first-line treatment regimens in patients with braf-mutated advanced colorectal cancer: a multicenter retrospective study
title_sort survival comparison of first line treatment regimens in patients with braf mutated advanced colorectal cancer a multicenter retrospective study
topic Advanced colorectal cancer
BRAF V600E mutation
Overall survival
Progression-free survival
url https://doi.org/10.1186/s12885-023-10640-9
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