PD-1 combined with surufatinib for the treatment of metastatic colon cancer with microsatellite stability and BRAF V600E mutation: A case report and review

doi:10.3877/cma.j.issn.2095-3224.2023.05.011

Abstract

Abstract:

BRAF mutation is found in approximately 12% of metastatic colorectal cancer (mCRC), with 90% mutation caused by V600E mutation, which has limited response to conventional therapies and poor prognosis. Here we present a case of an advanced colon cancer patient with BRAF V600E mutation. After a failed therapy with Bevacizumab and FOLFOXIRI, the disease progressed rapidly in the third-line treatment with Regorafenib. Then the patient was initiated on a regimen of sintilimab blockade and Surufatinib which had achieved partial response (PR).

Key words: Colonic neoplasms, Metastatic colorectal cancer, BRAF mutation, Surufatinib, Immunotherapy

Runzhi Chen, Dongmei Yang, Huiting Xu. PD-1 combined with surufatinib for the treatment of metastatic colon cancer with microsatellite stability and BRAF V600E mutation: A case report and review[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(05): 431-435.

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References 26

[1]	Siegel RL, Wagle NS, Cercek A, et al. Colorectal cancer statistics, 2023[J]. CA Cancer J Clin, 2023, 73(3): 233-254.
[2]	Shah MA, Renfro LA, Allegra CJ, et al. Impact of patient factors on recurrence risk and time dependency of oxaliplatin benefit in patients with colon cancer: analysis from modern-era adjuvant studies in the adjuvant colon cancer end points (ACCENT) database[J]. J Clin Oncol, 2016, 34(8): 843-853.
[3]	Modest DP, Pant S, Sartore-Bianchi A. Treatment sequencing in metastatic colorectal cancer[J]. Eur J Cancer, 2019, 109: 70-83.
[4]	Heinemann V, von Weikersthal LF, Decker T, et al. FOLFIRI plus cetuximab or bevacizumab for advanced colorectal cancer: final survival and per-protocol analysis of FIRE-3, a randomised clinical trial[J]. Br J Cancer, 2021, 124(3): 587-594.
[5]	Dai F, Shu L, Bian Y, et al. Safety of bevacizumab in treating metastatic colorectal cancer: a systematic review and meta-analysis of all randomized clinical trials[J]. Clin Drug Investig, 2013, 33(11): 779-788.
[6]	Cohen R, Rousseau B, Vidal J, et al. Immune checkpoint inhibition in colorectal cancer: microsatellite instability and beyond[J]. Target Oncol, 2020, 15(1): 11-24.
[7]	Diaz LAJr, Shiu KK, Kim TW, et al. Pembrolizumab versus chemotherapy for microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer (KEYNOTE-177): final analysis of a randomised, open-label, phase 3 study[J]. Lancet Oncol, 2022, 23(5): 659-670.
[8]	Yaeger R, Chatila WK, Lipsyc MD, et al. Clinical sequencing defines the genomic landscape of metastatic colorectal cancer[J]. Cancer Cell, 2018, 33(1): 125-136.e3.
[9]	Barras D, Missiaglia E, Wirapati P, et al. BRAF V600E mutant colorectal cancer subtypes based on gene expression[J]. Clin Cancer Res, 2017, 23(1): 104-115.
[10]	Kayhanian H, Goode E, Sclafani F, et al. Treatment and survival outcome of BRAF-mutated metastatic colorectal cancer: a retrospective matched case-control study[J]. Clin Colorectal Cancer, 2018, 17(1): e69-e76.
[11]	Sinicrope FA, Shi Q, Smyrk TC, et al. Molecular markers identify subtypes of stage III colon cancer associated with patient outcomes[J]. Gastroenterology, 2015, 148(1): 88-99.
[12]	Jones JC, Renfro LA, Al-Shamsi HO, et al. ^Non-V600 BRAF mutations define a clinically distinct molecular subtype of metastatic colorectal cancer[J]. J Clin Oncol, 2017, 35(23): 2624-2630.
[13]	Grothey A, Fakih M, Tabernero J. Management of BRAF-mutant metastatic colorectal cancer: a review of treatment options and evidence-based guidelines[J]. Ann Oncol, 2021, 32(8): 959-967.
[14]	Wu M, Kim YS, Ryu HS, et al. MSI status is associated with distinct clinicopathological features in BRAF mutation colorectal cancer: A systematic review and meta-analysis[J]. Pathol Res Pract, 2020, 216(1): 152791.
[15]	Samowitz WS, Sweeney C, Herrick J, et al. Poor survival associated with the BRAF V600E mutation in microsatellite-stable colon cancers[J]. Cancer Res, 2005, 65(14): 6063-6069.
[16]	Xu Q, Xu AT, Zhu MM, et al. Predictive and prognostic roles of BRAF mutation in patients with metastatic colorectal cancer treated with anti-epidermal growth factor receptor monoclonal antibodies: a meta-analysis[J]. J Dig Dis, 2013, 14(8): 409-416.
[17]	Cremolini C, Loupakis F, Antoniotti C, et al. FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as first-line treatment of patients with metastatic colorectal cancer: updated overall survival and molecular subgroup analyses of the open-label, phase 3 TRIBE study[J]. Lancet Oncol, 2015, 16(13): 1306-1315.
[18]	Tabernero J, Grothey A, Van Cutsem E, et al. Encorafenib plus cetuximab as a new standard of care for previously treated BRAF V600E-mutant metastatic colorectal cancer: updated survival results and subgroup analyses from the BEACON study[J]. J Clin Oncol, 2021, 39(4): 273-284.
[19]	Ros J, Matito J, Villacampa G, et al. Plasmatic BRAF-V600E allele fraction as a prognostic factor in metastatic colorectal cancer treated with BRAF combinatorial treatments[J]. Ann Oncol, 2023, 34(6): 543-552.
[20]	Voron T, Marcheteau E, Pernot S, et al. Control of the immune response by pro-angiogenic factors[J]. Front Oncol, 2014, (4): 70.
[21]	Franke AJ, Skelton WP, Starr JS, et al. Immunotherapy for colorectal cancer: a review of current and novel therapeutic approaches[J]. J Natl Cancer Inst, 2019, 111(11): 1131-1141.
[22]	Fukuoka S, Hara H, Takahashi N, et al. Regorafenib plus nivolumab in patients with advanced gastric or colorectal cancer: an open-label, dose-escalation, and dose-expansion phase Ib trial (REGONIVO, EPOC1603)[J]. J Clin Oncol, 2020, 38(18): 2053-2061.
[23]	Guo Y, Zhang W, Ying J, et al. Phase 1b/2 trial of fruquintinib plus sintilimab in treating advanced solid tumours: The dose-escalation and metastatic colorectal cancer cohort in the dose-expansion phases[J]. Eur J Cancer, 2023, 181: 26-37.
[24]	Yi M, Jiao D, Qin S, et al. Synergistic effect of immune checkpoint blockade and anti-angiogenesis in cancer treatment[J]. Mol Cancer, 2019, 18(1): 60.
[25]	Cassetta L, Kitamura T. Targeting tumor-associated macrophages as a potential strategy to enhance the response to immune checkpoint inhibitors[J]. Front Cell Dev Biol, 2018, (6): 38.
[26]	Cao Y, Lu M, Sun Y, et al. Surufatinib plus toripalimab in patients with advanced solid tumors: a single-arm, open-label, phase 1 trial[J]. J Cancer Res Clin Oncol, 2023, 149(2): 779-789.

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