BRAF...are there options we should be looking at?

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BRAF...are there options we should be looking at?

Postby highway61 » Wed Feb 06, 2019 4:34 pm

This is my first post here, but have been following a few threads. I'm in the UK and my brother in law was diagnosed at the end of August 2018. Stage IV, liver mets across most segments. He had very few symptoms prior to diagnosis and has company cover so got through tests and on to treatment pretty quick. Then the BRAF mutation was discovered and he was moved to FOLFOXIRI + Avastin and has had 8 cycles. Scan results were positive, great response in the primary which was potentially operable. The liver also responded well but not enough to be resectable - some large lesions had gone, but there was still enough activity to rule out surgery for now.

Decision was made to move to maintenance chemo (5FU I think) as a way of seeing how the disease would respond and asses whether there was a chance of coming off chemo for approx 12 weeks to take out the primary and recover, then look at options for the liver.

Unfortunately, there was progression in both primary and secondary after 2 cycles of maintenance (assuming the aggressive nature of BRAF) so the plan is go back to FOLFOXIRI + Avastin from next week. Obviously its only possible to have so many cycles of this treatment option.

While there has been some talk of other options eg. ablation and trials like Beacon and other BRAF inhibitors, he's worried that there are things he should be looking at now. He's got a good oncologist who mentioned places like MSK if he wanted a second opinion at any point. He has now been in touch with them and will be asking them to take a look.

I'm doing whatever reading I can, and it looks like there are all sorts of trials and new approaches being explored in this particular area. Does anyone have any pointers or advice or anything they think we should be looking at for him? If he is in contact with MSK, is there anything he should be asking them for specifically? This is such a great group of people and reading messages has already been a great help.

brother in law diagnosed 18/08 (age 37) based in UK
stage IV CRC ascending adenocarcinoma, squamous elements
liver mets in most segments
BRAF mutant, KRAS wild, NRAS wild, MMR normal
18/09 1 cycle FOLFIRI (+ Avastin maybe?)
genetic testing shows BRAF mutation
18/10 8 x cycles FOLFOXIRI + Avastin
v. good response in primary (operable), good response in liver but not resectable
maintenance 5FU 2 x cycles
progressed - new disease in primary and secondary
19/02 back to FOLFOXIRI + Avastin

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Re: BRAF...are there options we should be looking at?

Postby GrouseMan » Thu Feb 07, 2019 5:21 pm

Well you may want to have a look at the following: ... le/763563/

They have had pretty good success with using MEK inhibitors in Melanoma which have BRAF mutations so I am not surprised they have tried them in colon cancer. There are probably some clinical trials available for people with Colon Cancer and BRAF mutations. I believe DK37 was looking into some before he passed away if I recall correctly. You might want to look at the List at the top of the forum DK37 Science Posts Lists.

Good Luck

DW 53 dx Jun 2013
CT mets Liver Spleen lung. IVb CEA~110
Jul 2013 Sig Resct
8/13 FolFox,Avastin 12Tx mild sfx, Ongoing 5-FU Avastin every 3 wks.
CEA: good marker
7/7/14 CT Can't see the spleen Mets.
8/16/15 CEA Up, CT new abdominal mets. Iri, 5-FU, Avastin every 2 wks.
1/16 Iri, Erbitux and likely Avastin (Trial) CEA going >.
1/17 CEA up again dropped from Trial, Mets growth 4-6 mm in abdomen
5/2/17 Failed second trial, Hospitalized 15 days 5/11. Home Hospice 5/26, at peace 6/4/2017

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