treatment for advanced bowel cancer

Results from the recent BEACON CRC trial highlights a new triple therapy drug combination for the treatment of advanced bowel cancer.

Up to 15% of patients with advanced bowel cancer have a mutation in the BRAF gene. These patients have a poor prognosis for survival, especially in those who fail initial standard chemotherapy. These patients have an average overall survival of only four to six months. As a result, researchers have long been searching for an advanced bowel cancer treatment that can target the mutated BRAF gene. In the BEACON CRC trial, researchers from the United States investigated the effects of a three-drug combination treatment on overall survival in BRAF-mutated advanced bowel cancer. The results of the trial were published in Annals of Oncology.

The BEACON CRC trial is a multi-centre, randomized trial that evaluated the efficacy and safety of the combination of encorafenib, binimetinib, and cetuximab in patients with BRAF-mutant advanced bowel cancer who have failed initial standard therapies. They compared the results of the new triple therapy with a control group receiving standard combination treatment for advanced bowel cancer. The researchers assessed the overall survival rate and objective response rates.

The study included a total of 665 patients with BRAF-mutant advanced bowel cancer who had previously failed initial chemotherapy. The overall median survival for patients on the triple therapy was 9 months compared to 5.4 months in the standard treatment control group. The objective response rates observed in the study were 26% in the triple therapy group versus only 2% in the standard therapy group. The side effects observed in the study were as expected for the drug therapies being used, with the three-drug combination treatment being better tolerated than standard therapy.

The significant improvement in overall survival seen in the study’s results suggests a promising future for the treatment of advanced bowel cancer. Of note, the three-drug combination does not include any chemotherapy agents, meaning patients will be spared from the unpleasant side effects commonly experienced with chemotherapy.

In light of the trial’s results that demonstrate this triple-drug combination as a BRAF-targeted treatment that is better than previous standard treatments, the researchers stress the importance of BRAF mutation testing in all patients with bowel cancer. Based on the patient group studied in the trial, this targeted triple therapy should only be considered for patients who have previously failed initial standard chemotherapy. However, a clinical trial (ANCHOR-CRC) investigating triple therapy as a first-line choice for advanced bowel cancer treatment in patients with the BRAF-mutation is currently underway.

Written by Maggie Leung, PharmD

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References:

Kopetz, S., Grothey, A., Cutsem, E. V., Yaeger, R., Wasan, H., Yoshino, T., . . . Tabernero, J. (2019). LBA-006BEACON CRC: A randomized, 3-Arm, phase 3 study of encorafenib and cetuximab with or without binimetinib vs. choice of either irinotecan or FOLFIRI plus cetuximab in BRAF V600E–mutant metastatic colorectal cancer. Annals of Oncology,30(Supplement_4). doi:10.1093/annonc/mdz183.004

Targeted Therapy Combination Improves Survival in Patients with Advanced Bowel Cancer [ESMO World GI Press Release]. (2019, July 06). Retrieved from https://www.esmo.org/Press-Office/Press-Releases/ESMO-World-Congress-Gastrointestinal-Cancer-Encorafenib-Binimetinib-Cetuximab-Colorectal-BRAFV600E-Beacon-Kopetz

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