Long term response on Regorafenib in non-V600E BRAF mutated colon cancer: a case report

Eduard Callebout; Suzane Moura Ribeiro; Stephanie Laurent; Marc De Man; Liesbeth Ferdinande; Kathleen B M Claes; Joni Van der Meulen; Karen P Geboes

doi:10.1186/s12885-019-5763-5

Long term response on Regorafenib in non-V600E BRAF mutated colon cancer: a case report

BMC Cancer. 2019 Jun 11;19(1):567. doi: 10.1186/s12885-019-5763-5.

Authors

Eduard Callebout¹, Suzane Moura Ribeiro², Stephanie Laurent², Marc De Man², Liesbeth Ferdinande³, Kathleen B M Claes⁴, Joni Van der Meulen⁵, Karen P Geboes²

Affiliations

¹ Department of Gastroenterology, University Hospital Ghent, C Heymanslaan 10, 9000, Ghent, Belgium. [email protected].
² Department of Gastroenterology, University Hospital Ghent, C Heymanslaan 10, 9000, Ghent, Belgium.
³ Department of Pathology, University Hospital Ghent, C Heymanslaan 10, 9000, Ghent, Belgium.
⁴ Centre for Medical Genetics, University Hospital Ghent, C Heymanslaan 10, 9000, Ghent, Belgium.
⁵ Molecular Diagnostics, University Hospital Ghent, C Heymanslaan 10, 9000, Ghent, Belgium.

Abstract

Background: ^Non-V600E BRAF mutated colorectal cancer (CRC) is a rare disease entity with specific clinical features. These tumors are less likely to have microsatellite instability than CRC with a V600E BRAF mutation and often harbor a KRAS or NRAS mutation. Notably, median overall survival is longer than in wild-type BRAF CRC. Little is known about treatment possibilities in these patients.

Case presentation: We present the case of a 59 year old patient with a rare mutation in BRAF codon 594, who progressed rapidly on all classical therapies but experienced a clear and long lasting response on treatment with Regorafenib.

Conclusion: Little is known about therapies that can be effective in the rare ^non-V600E BRAF mutated CRCs. We present a patient who had a definite response to treatment with Regorafenib. There are no predictive markers that define a subset of CRC patients who benefit most from Regorafenib. The specific features of this ^non-V600E BRAF mutated CRC may be relevant in the exploration of predictive biomarkers for the efficacy of Regorafenib.

Keywords: Case report; Colon cancer; Epithelial to mesenchymal transition; Non-V600E BRAF mutation; Regorafenib.

Publication types

Case Reports

MeSH terms

Adenocarcinoma of Lung / drug therapy*
Adenocarcinoma of Lung / secondary
Antineoplastic Agents / administration & dosage
Antineoplastic Agents / therapeutic use*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Bevacizumab / therapeutic use
Biomarkers, Tumor / genetics
Carcinoembryonic Antigen / blood
Cetuximab / therapeutic use
Colonic Neoplasms / drug therapy*
Colonic Neoplasms / pathology
Colonic Neoplasms / radiotherapy
Colonic Neoplasms / surgery
Exons / genetics
Fluorouracil / therapeutic use
Follow-Up Studies
Humans
Leucovorin / therapeutic use
Lung Neoplasms / drug therapy*
Lung Neoplasms / secondary
Male
Middle Aged
Mutation*
Organoplatinum Compounds / therapeutic use
Phenylurea Compounds / administration & dosage
Phenylurea Compounds / therapeutic use*
Proto-Oncogene Proteins B-raf / genetics*
Pyridines / administration & dosage
Pyridines / therapeutic use*
Tomography, X-Ray Computed
Treatment Outcome

Substances

Antineoplastic Agents
Biomarkers, Tumor
Carcinoembryonic Antigen
Organoplatinum Compounds
Phenylurea Compounds
Pyridines
regorafenib
Bevacizumab
BRAF protein, human
Proto-Oncogene Proteins B-raf
Cetuximab
Leucovorin
Fluorouracil

Supplementary concepts

Folfox protocol