ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1608538
This article is part of the Research TopicReal-World Clinical and Translational Research in Gastrointestinal CancersView all articles
Clinical Impact of First-Line Therapeutic Strategies in BRAF V600E-Mutant Metastatic Colorectal Cancer: Real-World Evidence and Prognostic Insight
Provisionally accepted
- Division of Colorectal Surgery,Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
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Background: BRAF V600E-mutant metastatic colorectal cancer (mCRC) is associated with poor prognosis and limited response to standard therapies. Recent clinical trials have explored the benefit of targeted therapies, but real-world data remain limited.Methods: This retrospective study analyzed 36 patients with BRAF V600E-mutant mCRC who received first-line treatment between 2018 and 2024 at Taichung Veterans General Hospital. Patients were grouped by initial regimen: chemotherapy alone, chemotherapy plus anti-VEGF (bevacizumab), or chemotherapy combined with BRAF-targeted ± MEK inhibitors. Primary endpoints were overall survival (OS) and progression-free survival (PFS); secondary endpoints included objective response rate (ORR) and disease control rate (DCR).Results: Mean OS and PFS were longest in patients receiving chemotherapy plus anti-VEGF (21.2 and 10.5 months, respectively), compared to chemotherapy alone (OS 14 months, PFS 7.7 months) and anti-BRAF targeted therapy (OS 13.5 months, PFS 6.5 months). The highest ORR (53.8%) and DCR (76.9%) were observed in patients receiving BRAF-targeted regimens. Multivariate analysis identified liver metastasis and ECOG ≥2 as poor prognostic factors. Unexpectedly, right-sided tumors were associated with improved survival (HR: 0.20, p = 0.028). Subsequent use of BRAFtargeted therapy in some patients may have contributed to extended OS.Conclusions: In this real-world cohort, chemotherapy combined with anti-VEGF provided the best survival outcomes, while BRAF-targeted strategies showed promising response rates. Liver involvement and poor performance status remained negative prognostic indicators. These findings support a personalized treatment approach and highlight the need for continued prospective validation.
Keywords: BRAF V600E mutation, Metastatic colorectal cancer, Real-world evidence, first-line therapy, targeted treatment
Received: 09 Apr 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 YEH, CHIANG and Chiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
SHIH WEI CHIANG, Division of Colorectal Surgery,Department of Surgery, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
Feng Fen Chiang, Division of Colorectal Surgery,Department of Surgery, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
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