Therapeutic implications of b-raf mutations in colorectal cancer - Université de Lille
Article Dans Une Revue Journal of Visceral Surgery Année : 2021

Therapeutic implications of b-raf mutations in colorectal cancer

Résumé

Colorectal cancers (CRC) with B-RAF mutation carry a particularly poor prognosis. In this context, the value of first-line intensified chemotherapy associated with an anti-VEGF (Vascular endothelial growth factor) to treat metastatic CRC has recently been called into question. In patients with mutated B-RAF, the efficacy of first-line anti-EGFR (Epidermal Growth Factor Receptor) associated with chemotherapy for treatment of metastatic CRC is uncertain while that of anti-VEGF has been shown to be effective. The therapeutic pathways involving inhibition of B-RAF activity, although ineffective as monotherapy, have received marketing authorization when used in association with anti-EGFR for second-line treatment of metastatic CRC. Immunotherapy has provided very encouraging results in a recent phase III study in patients with microsatellite instability, irrespective of their B-RAF status. Finally, new therapies, targeting other RAF proteins and other specific receptors are currently under development. Surgery for liver metastases in patients with the B-RAF mutation should be considered whenever possible, after a complete search for peritoneal carcinomatosis and distant metastases, similarly to workup for patients without the B-RAF mutation.
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hal-04439817 , version 1 (22-07-2024)

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H. Lebrun, Anthony Turpin, P. Zerbib. Therapeutic implications of b-raf mutations in colorectal cancer. Journal of Visceral Surgery, 2021, Journal of visceral surgery, ⟨10.1016/j.jviscsurg.2021.04.002⟩. ⟨hal-04439817⟩
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