About this trial
This is a pilot trial which aims to assess the concept of anti-BRAF neoadjuvant treatment (encorafenib) in combination with cetuximab in patients with colon cancer or rT3/T4 supra-peritoneal upper rectal cancer based on a pre-operative CT-scan. About 10% of patients will have a mutated BRAF V600E tumour and the objective is to include 30 patients with this mutation.
If the tumour is not confirmed as a carrier of the BRAF V600E mutation or has an RAS mutation according to centralised assessment, treatment will be discontinued in this patient and cancer surgery will be organised as soon as possible. The patient will be excluded from the statistical analysis and will be replaced by a new patient in order to obtain 30 patients with confirmed BRAF V600E mutation and RAS wild type . It should be noted that less than a 3% discrepancy between the numbers of local laboratory results and central analysis results, has been reported in over 600 BRAF V600E mutated colon cancers in the BEACON CRC study. Based on these figures, there should be 0 or 1 patient with discrepant results in the study presented here.
Furthermore, in the hypothetical case of a patient who is an early permanent discontinuation of the study prior to surgery, this patient will be replaced in order to obtain a total of 30 patients who underwent surgery after neoadjuvant treatment.
Eligibility criteria
Qualifiers
Informed consent signed and dated by the patient and the investigator
Age ≥18 years at time of informed consent
Adenocarcinoma of the colon or of the upper rectum (supra-peritoneal) considered operable and histologically confirmed, localised, mutated BRAF V600E determined in a biopsy specimen and resectable after CT-scan assessment.
Tumour stage rT4 or rT3 with ≥ 5 mm extra-mural extension in a CT-scan.
Disqualifiers
Existence of distant metastases or adjacent nodules of peritoneal carcinosis (M1).
Existence of a dual-tumour location.
known RAS mutation
Peritonitis (secondary to perforation of the tumour) or symptomatic colonic occlusion or a temporary colostomy to prevent a sub-occlusion.
Trial design
Treatments tested in this trial
- Encorafenib Oral Capsule + Cetuximab
Treatment groups
Sponsors and collaborators
Federation Francophone de Cancerologie Digestive
Lead sponsor
Pierre Fabre Laboratories
Collaborator
Merck Sharp & Dohme LLC
Collaborator