A phase II study of daily encorafenib in combination with biweekly cetuximab in patients with BRAF V600E mutated metastatic colorectal cancer: the NEW BEACON study

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  • Martina Eriksen
  • Per Pfeiffer
  • Kristoffer Staal Rohrberg
  • Christina Westmose Yde
  • Lone Nørgård Petersen
  • Laurids Østergaard Poulsen
  • Qvortrup, Camilla

Background: Patients with BRAF V600E mutated metastatic colorectal cancer (mCRC) have a poor prognosis. The introduction of BRAF targeted therapy with encorafenib and weekly administered cetuximab have shown improved survival with a median progression free survival (PFS) of 4.3 months. However, a regimen with cetuximab given every second week may have comparable efficacy and is more convenient for patients. While BRAF targeted therapy is a new standard therapy in pre-treated patients with BRAF V600E mutated mCRC, resistance invariably occurs and is an emerging challenge. The aim of this study is to investigate the efficacy and tolerability of cetuximab given every second week in combination with daily encorafenib and to explore the correlation between markers of resistance and outcome. Methods: The study is an open label, single arm, phase II study, investigating the efficacy and tolerability of cetuximab given every second week in combination with encorafenib in patients with BRAF V600E mutated mCRC. Furthermore, we will be investigating mechanisms of response and resistance against BRAF targeted therapy though comprehensive genomic profiling on tumor tissue and blood for circulating tumor DNA analysis. A total of 53 patients (19 + 34 in two steps) will be included according to Simon’s optimal two stage design. The primary end point of the study is 2 months PFS rate. Discussion: By combining BRAF inhibitor with cetuximab given every second week we can halve the number of visits in the hospital compared to the currently approved regimen with weekly cetuximab. This seems particularly relevant in a group of patients with a median overall survival of 9.3 months. Resistance after initial response to targeted therapy can be either adaptive (e.g., epigenetic, or transcriptomic alterations) or acquired (selective genetic alterations - e.g., activating de novo mutations) resistance. It is of great importance to untangle these complex mechanisms of resistance in patients with BRAF V600E mutated mCRC to improve treatment strategies in the future potentially even further. Trial registration: EU Clinical Trial Register, Eudract no. 2020-003283-10. Registered on 11 November 2020.

OriginalsprogEngelsk
Artikelnummer1321
TidsskriftBMC Cancer
Vol/bind22
Udgave nummer1
ISSN1471-2407
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This work is further supported financially by a grant from the patient organization the Danish Cancer Society of 2,500,000 DKK.

Funding Information:
KSR reports having received personal fees from Bayer and Amgen and paid travel and accommodation expenses from Roche and Bristol-Myers Squibb. Besides this KRS reports having received research grants for his institution from the following: Lilly, Roche/Genentech, Bristol-Myers Squibb, Symphogen, Pfizer, Novartis, Loxo, Bayer, Alligator Bioscience, Incyte, Cantargia AB, Genmab, Puma Biotechnology, Orion Clinical, Monta BioScience, and Bioinvent.

Funding Information:
This work was supported financially by a grant from Pierre Fabre Medicament of 135,000 EUR and by covering of the expenses related to the medical product encorafenib.

Publisher Copyright:
© 2022, The Author(s).

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