A combination of targeted therapies can improve survival in patients with advanced bowel cancer and should replace chemotherapy, new data has revealed.
Delegates at the ESMO World Congress on Gastrointestinal Cancer 2019, Barcelona, Spain, heard this weekend that the results of the BEACON CRC Phase III trial have shown that triple therapy targeting BRAF mutations in progressive metastatic colorectal tumours significantly improved overall survival and objective response compared to standard care.
The data suggest that the three-drug combination of encorafenib, binimetinib and cetuximab should replace chemotherapy for the one in seven patients with metastatic colorectal cancer who have a BRAF mutation.
Study author Dr Scott Kopetz, from the UT MD Anderson Cancer Center, Houston, USA, described the results as “very exciting”.
He added: “It’s encouraging to see such a significant improvement in overall survival and response in patients with such aggressive tumour biology. Hopefully, this will soon lead to increased access to this treatment for patients where there is currently such a large unmet need.”
Dr Kopetz told the conference that the three-drug combination builds on growing understanding of the activation of cancer genes such as BRAF and the effects of targeted therapies.
"Colorectal cancer does not respond to BRAF therapy alone because tumour cells adapt through other mechanisms after initial treatment,” he said.
“With this triple targeted therapy, we are using a very scientifically logical combination to inhibit BRAF and these other mechanisms.”
In the global BEACON CRC study, 665 patients with BRAF V600E-mutant colorectal cancer who had progressed after one or two prior regimens in the metastatic setting were randomised to receive triplet therapy, doublet therapy (encorafenib and cetuximab) or the investigator’s choice of irinotecan or folinic acid, fluoruracil and irinotecan (FOLFIRI) and cetuximab.
Median overall survival was nine months for the triplet targeted therapy compared to 5.4 months for standard therapy.
An ongoing study (ANCHOR-CRC) is investigating the effects of triplet therapy as first-line treatment for patients with metastatic BRAF V600E-mutant colorectal cancer.
BEACON 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 was presented by Scott Kopetz.
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