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BRAF 突变型结直肠癌,一种进化中的异类。

BRAF-mutant colorectal cancer, a different breed evolving.

机构信息

a Medical Oncology , Sapienza-University of Rome , Rome , Italy.

b Medical Oncology Unit , University Hospital and University of Cagliari , Cagliari , Italy.

出版信息

Expert Rev Mol Diagn. 2018 Jun;18(6):499-512. doi: 10.1080/14737159.2018.1470928. Epub 2018 May 9.

DOI:10.1080/14737159.2018.1470928
PMID:29708446
Abstract

BRAF mutant colorectal cancer (BRAF MT CRC) is a unique category of colorectal tumour with peculiar molecular, pathological and clinical features and poor prognosis; despite recent research, BRAF mutation predictive value and standard treatment of BRAF MT CRC still have to be defined. In this review, we focused on this challenging topic. Areas covered: The potential use of BRAF mutational status among recent additional prognostic and predictive indicators and current treatment strategy in use in these patients is discussed. Moreover, implications and characteristics of new BRAF mutations other than BRAFV600E are analyzed. An in-deep outlook on the immediate future for clinical and translational research in this subgroup of patients is also presented, such as combination therapy with agents targeting the RAS/RAF/MEK/ERK pathway and standard chemotherapy in order to overcome resistance. We performed a research on Pubmed typing 'BRAF mutation', 'colorectal cancer', 'predictive and prognostic value', 'targeted therapy', 'BRAF inhibition'. Expert commentary: BRAFV600E mutation represents a strong, independent negative prognostic factor in II-III stage MSS CRC and mCRC. The best treatment still has to be identified; currently, in good performance status patients, an intensive-chemotherapy-combination remains the standard of care. Further investigations are warranted to explore new horizons to change BRAF MT mCRC outcomes.

摘要

BRAF 突变型结直肠癌(BRAF MT CRC)是一种具有独特分子、病理和临床特征以及预后不良的结直肠肿瘤独特类别;尽管最近进行了研究,但仍需要确定 BRAF 突变预测价值和 BRAF MT CRC 的标准治疗方法。在这篇综述中,我们重点介绍了这个具有挑战性的主题。

涵盖的领域

讨论了 BRAF 突变状态在最近的其他预后和预测指标中的潜在用途,以及当前在这些患者中使用的治疗策略。此外,还分析了 BRAFV600E 以外的新 BRAF 突变的意义和特征。还深入探讨了该患者亚组临床和转化研究的近期前景,例如针对 RAS/RAF/MEK/ERK 通路的联合治疗以及标准化疗,以克服耐药性。

我们在 Pubmed 上以“BRAF 突变”、“结直肠癌”、“预测和预后价值”、“靶向治疗”、“BRAF 抑制”进行了研究。

专家评论

BRAFV600E 突变是 II-III 期 MSS CRC 和 mCRC 中强有力的独立预后不良因素。仍需要确定最佳治疗方法;目前,在身体状况良好的患者中,强化化疗联合治疗仍然是标准治疗。需要进一步研究以探索改变 BRAF MT mCRC 结果的新途径。

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Expert Rev Mol Diagn. 2018 Jun;18(6):499-512. doi: 10.1080/14737159.2018.1470928. Epub 2018 May 9.
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