Successful Management of BRAF V600E-Mutated Metastatic Colorectal Cancer With Liver Dysfunction Using...

Area of Science:

• Oncology
• Gastroenterology
• Pharmacology

Background:

• The standard of care for BRAF V600E-mutated metastatic colorectal cancer (mCRC) is encorafenib, cetuximab, and FOLFOX.
• Patients with significant liver dysfunction are often excluded from clinical trials, leaving their treatment unclear.
• This case addresses the treatment of BRAF V600E-mutated mCRC in a patient with extensive hepatic involvement.

Purpose of the Study:

• To report the safety and efficacy of encorafenib, cetuximab, and FOLFOX in a patient with BRAF V600E-mutated mCRC and liver dysfunction.
• To evaluate treatment response and tolerability in a challenging patient population.
• To assess the potential for surgical resection after neoadjuvant therapy.

Main Methods:

• A single case report of a patient with BRAF V600E-mutated mCRC and liver dysfunction.
• Initiation of full-dose encorafenib, cetuximab, and FOLFOX despite absence of specific guidelines.
• Monitoring of clinical and biochemical response, adverse events, and post-treatment molecular profiling.
• Surgical resection of primary tumor and metastatic disease.

Main Results:

• Rapid clinical and biochemical response, with near-normalization of liver enzymes after cycle 1.
• Complete functional liver recovery by cycle 3.
• Treatment was well tolerated over 9 cycles with no significant adverse events.
• Posttreatment molecular profiling revealed no residual actionable mutations.
• Successful complete surgical resection with negative margins.

Conclusions:

• Encorafenib-based therapy can be considered in select patients with BRAF V600E-mutated mCRC and compromised liver function.
• This approach may lead to significant tumor response and enable curative-intent surgery.
• Further investigation into this patient population is warranted.