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Colorectal Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersColorectal CancerSCE Medical Oncology

A 70-year-old man with metastatic colorectal cancer has an incidental finding of a BRAF V600E mutation on NGS. His tumour is MSS (microsatellite stable). What is the prognostic significance of BRAF V600E in MSS colorectal cancer?

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Correct answer: E — Very poor prognosis — BRAF V600E in MSS CRC is associated with aggressive biology and reduced overall survival

BRAF V600E mutation in MSS colorectal cancer is an independent adverse prognostic marker associated with right-sided tumours, peritoneal metastases, poor response to standard chemotherapy, and reduced OS (median approximately 11 months for MSS/BRAF-mutant vs 24+ months for MSS/BRAF-WT). Notably, BRAF V600E in MSI-H CRC has a less adverse prognosis. Targeted therapy (encorafenib + cetuximab) is now available for second-line (NICE TA868).

Reference: ESMO 2024 Metastatic Colorectal Cancer Guidelines; BEACON CRC trial; Tran et al Cancer 2011