WJOG13219G: The Efficacy and Safety of FOLFOXIRI or Doublet plus Anti-VEGF Therapy in Previously Untreated BRAFV600E Mutant Metastatic Colorectal Cancer: A Multi-Institutional Registry-Based Study (BRACELET Study)

Keitaro Shimozaki, Kenro Hirata, Taro Sato, Maho Nakamura, Kyoko Kato, Hidekazu Hirano, Yosuke Kumekawa, Kaori Hino, Kentaro Kawakami, Yosuke Kito, Toshihiko Matsumoto, Takeshi Kawakami, Masato Komoda, Kengo Nagashima, Yasunori Sato, Kentaro Yamazaki, Shuichi Hironaka, Hiromasa Takaishi, Yasuo Hamamoto, Kei Muro

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The real-world survival benefit of FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) plus anti-VEGF therapy (Triplet) over doublet chemotherapy (Doublet) remains controversial in patients with BRAFV600E mutant metastatic colorectal cancer (mCRC). Patients and Methods: WJOG13219G was a multicenter, retrospective, registry-based study of patients with BRAFV600E mutant mCRC who received first-line triplet or doublet chemotherapy from January 2014 to December 2019 in Japan. Inverse probability of treatment weighting (IPTW) was used to adjust for patient background. Results: The analysis included 79 and 91 patients in the Triplet and Doublet groups, respectively. The Triplet group was significantly younger and had better performance status. No statistical difference was noted in progression-free survival (PFS; HR, 0.82; 95% CI, 0.60–1.13; P = .22) and overall survival (OS; HR, 0.88; 95% CI, 0.62–1.25; P = .48) between both groups. IPTW analysis also showed no difference between the 2 groups in PFS (HR, 0.86; 95% CI, 0.69–1.08; P = .20) and OS (HR, 0.93; 95% CI, 0.73–1.20; P = .59). The Triplet and Doublet groups had an objective response rate of 53% and 41%, respectively (P = .10). At least one grade 3 or 4 adverse event was seen in 51 (65%) and 43 (47%) patients in the Triplet and Doublet groups, respectively, with the incidence of neutropenia being significantly higher in the former. Conclusion: Triplet therapy had no survival benefit versus doublet therapy in the overall and IPTW cohorts or specific subgroups for real-world patients with BRAFV600E mutant mCRC.

Original languageEnglish
JournalClinical Colorectal Cancer
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • BRAF
  • Doublet
  • FOLFOXIRI
  • Metastatic colorectal cancer
  • TRIBE
  • Triplet

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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