The therapeutic potential of targeting the BRAF mutation in patients with colorectal cancer

J Cell Physiol. 2018 Mar;233(3):2162-2169. doi: 10.1002/jcp.25952. Epub 2017 May 23.

Abstract

Colorectal cancer is among the most lethal malignancies globally. BRAF is a member of the RAS/RAF/MEK/ERK signaling pathway. Its constitutive activation can result in increased cellular growth, development, invasion, and resistance to therapy. A mutation of the BRAF gene is present in 5-10% of metastatic colorectal cancers. BRAF mutations have been found to predict a lack of benefit to anti-EGFR therapy in metastatic CRC. Furthermore, CRC containing the BRAF V600E mutation display an innate resistance to BRAF inhibitors. The mechanisms of cell resistance can be explained at least in part by ERK dependent and ERK in-dependent pathway. Clinical trials evaluating the combinations of BRAF, PI3K, EGFR, and/or MEK inhibitors have revealed promising activity in BRAF mutant containing CRCs. There may be some benefit from future studies that focus on improving the efficacy of combined therapy in CRC with respect to the sustained effects. The aim of current review is to give an overview about the current status and prospective regarding the therapeutic potential of targeting BRAF mutant colorectal cancer.

Keywords: BRAF mutation; RAS/RAF/MEK/ERK pathway; colorectal cancer; target therapy.

Publication types

  • Review

MeSH terms

  • Amino Acid Substitution / genetics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carbamates / therapeutic use
  • Cinnamates / therapeutic use
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / pathology
  • Drug Resistance, Neoplasm / genetics
  • ErbB Receptors / antagonists & inhibitors
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Humans
  • Imidazoles / therapeutic use
  • Indoles / therapeutic use
  • MAP Kinase Kinase Kinases / antagonists & inhibitors
  • Oximes / therapeutic use
  • Phosphoinositide-3 Kinase Inhibitors
  • Piperazines / therapeutic use
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors*
  • Proto-Oncogene Proteins B-raf / genetics*
  • Sulfonamides / therapeutic use
  • Vemurafenib

Substances

  • 4-(3-(3-chloro-4-fluorophenyl)acryloyl)-1-(3-(4-hydroxy-6-azaspiro(2.5)oct-6-yl)propyl)-3-methylpiperazin-2-one
  • Carbamates
  • Cinnamates
  • Imidazoles
  • Indoles
  • Oximes
  • Phosphoinositide-3 Kinase Inhibitors
  • Piperazines
  • Sulfonamides
  • Vemurafenib
  • encorafenib
  • EGFR protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins B-raf
  • Extracellular Signal-Regulated MAP Kinases
  • MAP Kinase Kinase Kinases
  • dabrafenib