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Goutham Sunny: Key Findings from BRAF V600E in MSI-H mCRC

Goutham Sunny/LinkedIn

Jul 16, 2025, 05:56

Goutham Sunny: Key Findings from BRAF V600E in MSI-H mCRC

Goutham Sunny, Former Resident Doctor at The Gujarat Cancer and Research Institute, shared a post on X:

“BRAF V600E in MSI-H mCRC: No OS Impact Overall, But Higher 1L Resistance

Retrospective cohort (n=909) of MSI-H/dMMR mCRC patients treated with ICIs (2014–2023), evaluating prognostic impact of BRAF V600E mutation.

Key Findings:

– BRAF mutation (BRAFm) present in 38% (345/909)
– Across all lines of ICI therapy:

• No difference in PFS (25.0 vs 41.5 mo, adjHR 0.97, p=0.8)
• No difference in OS (55.1 mo vs not reached, adjHR 0.98, p=0.9)

First-Line ICI Subset:

– Higher secondary resistance in BRAFm: 20% vs 11% (p=0.02)
– Among those with disease control ≥6 mo:

• BRAFm had shorter PFS (adjHR 2.09, p=0.03)
• and shorter OS (adjHR 2.80, p=0.019)

– Dual ICI (anti-PD1 + anti-CTLA4) eliminated this negative prognostic impact

Clinical Implication for Oncologists:

– In MSI-H/dMMR mCRC, BRAF V600E is not universally prognostic on ICI
– But in 1L setting, BRAFm pts face higher secondary resistance and worse post-progression outcomes
– Dual checkpoint blockade may overcome this disadvantage—supports combination ICI use upfront in BRAFm MSI-H mCRC”

Title: Prognostic impact of the BRAF V600E mutation in patients with MSI-high metastatic colorectal cancer treated with immune checkpoint inhibitors

Authors: Claire Gallois, Margherita Ambrosini, Sara Lonardi, Emily Alouani, Rosine Guimbaud, Michael J. Overman, Frank Sinicrope, Thibault Mazard, Marie Decraecker, Javier Ros, Elena Elez, Simon Pernot, Chiara Cremolini, Alice Boilève, Pauline Parent, Priya Jayachandran, Marie Dutherage, Mathilde Mercier, Clémence Flecchia, Marwan Fakih, Francesco Sclafani, Filippo Pietrantonio, Julien Taieb, David Tougeron

You can read the Full Article in the European Journal of Cancer.

Goutham Sunny: Key Findings from BRAF V600E in MSI-H mCRC

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Alice Boilève cancer Chiara Cremolini Claire Gallois Clémence Flecchia Colon cancer David Tougeron Elena Elez Emily Alouani Filippo Pietrantonio Francesco Sclafani Frank Sinicrope Goutham Sunny Javier Ros Julien Taieb Margherita Ambrosini Marie Decraecker Marie Dutherage Marwan Fakih Mathilde Mercier Michael J. Overman MSI-H mCRC OncoDaily Oncology Pauline Parent Priya Jayachandran Rosine Guimbaud Sara Lonardi Simon Pernot Thibault Mazard

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