Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study
<i>Background and Objectives</i>: Approximately 5–10% of all patients with metastatic colorectal cancer (mCRC) harbor a <i>BRAF<sup>V600E</sup></i> mutation. These patients exhibit distinct metastatic patterns, poor prognosis, and heterogenous survival outcomes. T...
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MDPI AG
2023-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/12/2108 |
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| author | Hsiang-Lin Tsai Ching-Wen Huang Yen-Cheng Chen Wei-Chih Su Tsung-Kun Chang Po-Jung Chen Ching-Chun Li Yu-Tang Chang Jaw-Yuan Wang |
| author_facet | Hsiang-Lin Tsai Ching-Wen Huang Yen-Cheng Chen Wei-Chih Su Tsung-Kun Chang Po-Jung Chen Ching-Chun Li Yu-Tang Chang Jaw-Yuan Wang |
| author_sort | Hsiang-Lin Tsai |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Approximately 5–10% of all patients with metastatic colorectal cancer (mCRC) harbor a <i>BRAF<sup>V600E</sup></i> mutation. These patients exhibit distinct metastatic patterns, poor prognosis, and heterogenous survival outcomes. The findings from the TRIBE study indicated that the administration of FOLFOXIRI plus bevacizumab as first-line treatment extended the median duration of overall survival (OS). In this study, we explored the effects of <i>UGT1A1</i> polymorphism on the outcomes of irinotecan dose escalation versus FOLFOXIRI plus bevacizumab in patients with <i>BRAF<sup>V600E</sup></i>-mutant mCRC. <i>Materials and Methods</i>: We retrospectively reviewed the medical records of 25 patients who had received a diagnosis of <i>BRAF<sup>V600E</sup></i>-mutant mCRC between October 2015 and August 2022. All patients underwent <i>UGT1A1</i> genotyping before receiving bevacizumab plus FOLFIRI. The primary end point was progression-free survival (PFS), and secondary endpoints were OS and adverse events (AEs). The two treatment arms were compared in terms of 6-month PFS and 12-month OS. <i>Results</i>: Over a median follow-up duration of 15.0 (interquartile range, 10.0–30.5) months, no significant differences were noted between the treatment arms in severe AEs (SAEs), 6-month PFS, or 12-month OS (all <i>p</i> < 0.05). Regarding AEs, the FOLFIRI plus bevacizumab regimen was associated with a lower incidence of anorexia than was the FOLFOXIRI plus bevacizumab regimen (<i>p</i> = 0.042). <i>Conclusions</i>: Our findings indicate that FOLFIRI plus bevacizumab with irinotecan dose escalation is an effective first-line treatment regimen for patients with <i>BRAF<sup>V600E</sup></i>-mutant mCRC. This regimen leads to acceptable clinical outcomes with manageable AEs. However, the effects on survival and safety outcomes could only be speculated, and further studies are needed because of the sample size, the follow-up for the OS evaluation, and the non-uniformity in all the variables considered in the two groups. |
| first_indexed | 2024-03-08T20:33:19Z |
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| id | doaj.art-fdab3b5083a14fe8a83a26180c2d9407 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-08T20:33:19Z |
| publishDate | 2023-12-01 |
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| series | Medicina |
| spelling | doaj.art-fdab3b5083a14fe8a83a26180c2d94072023-12-22T14:23:49ZengMDPI AGMedicina1010-660X1648-91442023-12-015912210810.3390/medicina59122108Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational StudyHsiang-Lin Tsai0Ching-Wen Huang1Yen-Cheng Chen2Wei-Chih Su3Tsung-Kun Chang4Po-Jung Chen5Ching-Chun Li6Yu-Tang Chang7Jaw-Yuan Wang8Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan<i>Background and Objectives</i>: Approximately 5–10% of all patients with metastatic colorectal cancer (mCRC) harbor a <i>BRAF<sup>V600E</sup></i> mutation. These patients exhibit distinct metastatic patterns, poor prognosis, and heterogenous survival outcomes. The findings from the TRIBE study indicated that the administration of FOLFOXIRI plus bevacizumab as first-line treatment extended the median duration of overall survival (OS). In this study, we explored the effects of <i>UGT1A1</i> polymorphism on the outcomes of irinotecan dose escalation versus FOLFOXIRI plus bevacizumab in patients with <i>BRAF<sup>V600E</sup></i>-mutant mCRC. <i>Materials and Methods</i>: We retrospectively reviewed the medical records of 25 patients who had received a diagnosis of <i>BRAF<sup>V600E</sup></i>-mutant mCRC between October 2015 and August 2022. All patients underwent <i>UGT1A1</i> genotyping before receiving bevacizumab plus FOLFIRI. The primary end point was progression-free survival (PFS), and secondary endpoints were OS and adverse events (AEs). The two treatment arms were compared in terms of 6-month PFS and 12-month OS. <i>Results</i>: Over a median follow-up duration of 15.0 (interquartile range, 10.0–30.5) months, no significant differences were noted between the treatment arms in severe AEs (SAEs), 6-month PFS, or 12-month OS (all <i>p</i> < 0.05). Regarding AEs, the FOLFIRI plus bevacizumab regimen was associated with a lower incidence of anorexia than was the FOLFOXIRI plus bevacizumab regimen (<i>p</i> = 0.042). <i>Conclusions</i>: Our findings indicate that FOLFIRI plus bevacizumab with irinotecan dose escalation is an effective first-line treatment regimen for patients with <i>BRAF<sup>V600E</sup></i>-mutant mCRC. This regimen leads to acceptable clinical outcomes with manageable AEs. However, the effects on survival and safety outcomes could only be speculated, and further studies are needed because of the sample size, the follow-up for the OS evaluation, and the non-uniformity in all the variables considered in the two groups.https://www.mdpi.com/1648-9144/59/12/2108<i>BRAF<sup>V600E</sup></i> mutationmetastatic colorectal cancer<i>UGT1A1</i> polymorphismirinotecan dose escalationprogression-free survivaloverall survival |
| spellingShingle | Hsiang-Lin Tsai Ching-Wen Huang Yen-Cheng Chen Wei-Chih Su Tsung-Kun Chang Po-Jung Chen Ching-Chun Li Yu-Tang Chang Jaw-Yuan Wang Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study Medicina <i>BRAF<sup>V600E</sup></i> mutation metastatic colorectal cancer <i>UGT1A1</i> polymorphism irinotecan dose escalation progression-free survival overall survival |
| title | Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study |
| title_full | Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study |
| title_fullStr | Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study |
| title_full_unstemmed | Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study |
| title_short | Real-World Outcomes of First-Line FOLFIRI Plus Bevacizumab with Irinotecan Dose Escalation versus FOLFOXIRI Plus Bevacizumab in <i>BRAF<sup>V600E</sup></i>-Mutant Metastatic Colorectal Cancer: The Preliminary Data from a Single-Center Observational Study |
| title_sort | real world outcomes of first line folfiri plus bevacizumab with irinotecan dose escalation versus folfoxiri plus bevacizumab in i braf sup v600e sup i mutant metastatic colorectal cancer the preliminary data from a single center observational study |
| topic | <i>BRAF<sup>V600E</sup></i> mutation metastatic colorectal cancer <i>UGT1A1</i> polymorphism irinotecan dose escalation progression-free survival overall survival |
| url | https://www.mdpi.com/1648-9144/59/12/2108 |
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