BRAF V600E-mutant colorectal cancer with CNS metastases treated successfully with encorafenib, binimetinib and cetuximab

Abstract

This report describes a case of BRAF V600E-mutated colorectal cancer with CNS metastases in which treatment with encorafenib, binimetinib and cetuximab was effective. There is limited information on the ability of encorafenib, binimetinib and cetuximab to enter the CNS.

The patient was a 53-year-old man was diagnosed with ascending colon cancer (cT3N3M1c stage IVc). BRAF V600E mutation was confirmed. FOLFOX was started, but CNS metastases soon appeared. Encorafenib, binimetinib and cetuximab were administered and had a favorable effect on the CNS lesions. The patient initially responded well, but his disease progressed 2 months later. Further research is needed to improve management strategies for BRAF V600E-mutated colorectal cancer with CNS metastases.

Executive summary

• A combination of encorafenib, binimetinib and cetuximab demonstrated effectiveness in BRAF V600E-mutated colorectal cancer with CNS metastases.

• Treating brain metastasis in colorectal cancer is challenging because of the limited ability of drugs to penetrate the CNS.

• Although an initial response was observed, early disease progression suggested the existence of mechanisms of resistance to EGFR/BRAF inhibitors.

• Further research is needed to establish the efficacy of this treatment and improve management strategies.

Keywords: :

• binimetinib
• BRAF V600E
• central nervous system
• cetuximab
• colorectal cancer
• encorafenib
• metastasis

Author contributions

All listed authors participated in the writing of the manuscript and have read and approved the final version.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The Institutional Review Board of National Cancer Center Hospital, Japan approved the case report and its submission to the medical literature (2017-229).