BRAF V600E-mutant colorectal cancer with CNS metastases treated successfully with encorafenib, binimetinib and cetuximab

Abstract

This report describes a case of BRAF V600E-mutated colorectal cancer with CNS metastases in which treatment with encorafenib, binimetinib and cetuximab was effective. There is limited information on the ability of encorafenib, binimetinib and cetuximab to enter the CNS.

The patient was a 53-year-old man was diagnosed with ascending colon cancer (cT3N3M1c stage IVc). BRAF V600E mutation was confirmed. FOLFOX was started, but CNS metastases soon appeared. Encorafenib, binimetinib and cetuximab were administered and had a favorable effect on the CNS lesions. The patient initially responded well, but his disease progressed 2 months later. Further research is needed to improve management strategies for BRAF V600E-mutated colorectal cancer with CNS metastases.

Abstract

Executive summary

• A combination of encorafenib, binimetinib and cetuximab demonstrated effectiveness in BRAF V600E-mutated colorectal cancer with CNS metastases.

• Treating brain metastasis in colorectal cancer is challenging because of the limited ability of drugs to penetrate the CNS.

• Although an initial response was observed, early disease progression suggested the existence of mechanisms of resistance to EGFR/BRAF inhibitors.

• Further research is needed to establish the efficacy of this treatment and improve management strategies.