Current landscape of BRAF-V600E metastatic CRC management in Latin America: an expert Latin American panel's recommendations

Abstract

Colorectal cancer is the second leading cause of cancer death in Latin America (LA) with a projected 65.4% increase by 2040. Up to 10% of metastatic CRC (mCRC) patients in LA had an activating BRAF mutation. In clinical trials, targeted therapies for BRAF-V600E mutated mCRC have improved patient outcomes. However, in LA, BRAF-V600E testing and treatment of positive patients remains variable. To address this need, the Americas Health Foundation convened a meeting of LA experts on BRAF-V600E mCRC to develop treatment recommendations. The expert panel addressed the current landscape of BRAF-V600E mCRC testing, diagnosis and treatment in the region and identified significant limitations. Local guidelines, multidisciplinary boards, and tumor genotyping are among the recommendations. The panel also made first-line, second-line and surgery recommendations for patients after diagnosis.

Keywords: V600E-BRAF mCRC; V600E-BRAF-mutation; mCRC in Latin America; metastatic colorectal cancer; precision medicine.

Figure 1.. BRAF-V600E CRC prevalence in LA. Data taken from published studies [–18].

Figure 2.. BRAF-V600E mCRC assessment decision tree. Oncologists in LA apply a summarised decision algorithm to detecting MSS/MSI status and mutational status among mCRC patients.