[DNA mismatch repair and BRAF status in colorectal cancer: Interest for the therapeutic management?]

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in France. Recently, colorectal cancer subtyping consortium (CRCSC) identified 4 consensus molecular subtypes (CMS). CMS1 is enriched for CRC with deficient DNA mismatch repair system (dMMR) and tumors with mutated BRAF. Intriguingly, CMS1 is characterized by better relapse-free survival but worse survival after relapse, compared with the other subtypes. In this review, we provide a comprehensive overview of prognostic and predictive impacts of MMR and BRAF status. We highlight immune checkpoints inhibitors as potentially future therapeutics for CRC with deficient MMR. We also focus on the management of BRAF mutant metastatic CRC, with a particular interest on targeted therapies.

Keywords: Adjuvant treatment; BRAF; Cancer colorectal; Colorectal cancer; Mismatch repair system; Statut microsatellite; Targeted therapies; Thérapies ciblées; Traitement adjuvant.