Surgical and Oncologic Outcomes in Patients with BRAF-Mutated Colorectal Cancer Following Targeted Therapy and Hepatic Resection with Curative Intent

Abstract

Background: BRAF V600E mutations are present in up to 10% of patients with metastatic colorectal cancer (mCRC) and portend poor prognosis. Recently, a new class of drugs acting along the BRAF signaling pathway became available as an adjunctive treatment option. Aim: To describe the surgical short-term and the oncologic outcomes in patients with mCRC following BRAF targeted therapy with the RAF inhibitor encorafenib and subsequent liver resection. Methods: Using retrospective clinical and molecular data, patients with BRAF V600E mCRC who received systemic treatment with encorafenib and after liver resection. Results: Four patients were identified. Patients characteristics included median age 66 years, 75% female, 75% with right-sided tumors. All patients underwent primary tumor resection, followed by adjuvant chemotherapy. Among second- and third- line treatments, all patients had received BRAF targeted therapy and subsequent liver resections: 75% and 25% underwent minor and major liver resections, respectively. Median EBL was 75 mL, minor/major complications occurred in 50% and 0% of cases, median LOS was 4 days. Median overall survival (OS) was 47 months and median progression-free survival (PFS) was 17 months. All were alive at follow-up with active disease. Conclusion: BRAF targeted therapy constitutes a novel treatment option in a subset of patients with colorectal cancer. In a small cohort of patients treated with targeted therapy and curative intent liver resection for metastatic disease, the oncologic outcomes were superior to prior published results with no obvious impact on surgical complication rate.