Global BRAF testing practices in metastatic colorectal cancer (mCRC).

Abstract

e15523 Background: The BRAF V600E mutation is a marker of poor prognosis in patients with mCRC. Targeted therapy, such as encorafenib + cetuximab, is approved in the US/Europe for the treatment of BRAF V600E-mutated mCRC and demonstrated improved survival vs historical standard of care (SOC). Determining BRAF mutation status in mCRC is recommended by NCCN and ESMO guidelines; although adherence to these guidelines may not be uniform. This report’s objective is to communicate global survey results of mCRC BRAF testing practices. Identifying regions where BRAF testing is not SOC may help identify where education efforts are needed to improve effective treatment decision making. Methods: Oncology treatment centers were identified from a registry and from public information. Centers were selected for research experience, historic data quality, and estimated numbers of mCRC patients. A BRAF testing practices survey using an online platform of verified centers was conducted from March to November 2020; 425 sites in 39 countries responded. Results: BRAF testing is performed as SOC most commonly in Northern and Western Europe (97%) and East Asia (95%). Conversely, BRAF testing as SOC is least common in Eastern Europe (47%) and South America (52%). Surveyed regions generally test patients when confirming advanced disease prior to first-line (1L) treatment (35% to 78%) or at initial histological diagnosis (9% to 41%). Most regions test tumor tissue; few test both tumor tissue and blood; and none conduct blood mutation testing only. Testing practices in the US by type of site (academic vs community) will be presented. Conclusions: BRAF testing has global variability, impacting treatment decisions. Increased awareness and routine testing may lead to informed decisions regarding targeted therapies, such as encorafenib + cetuximab (where approved), in patients with BRAF V600E-mutant mCRC.[Table: see text]