BRAF (v-Raf murine sarcoma viral oncogene homolog B) mutation is a rare oncogenic driver in NSCLC (2%) and few data are published on the management of these patients (pts) outside patients included in clinical trial. Objective: to investigate clinical characteristics and management of these patients in real world setting.
Inclusion of pts with a diagnosis of NSCLC harboring BRAF mutations between January 2012 and December 2014, collection of demographic and clinical characteristics, risk factors, Progression Free Survival (PFS), Overall Survival (OS), mode of progression and therapeutic management; sub group analysis according to the BRAF mutation (V600E versus others).
59 patients recruited in 24 centers: 34 (57,6%) men; age: 64,5 ± 14,5 years; PS 0/1 at diagnosis: 82%; current/former smokers: 23 (40,3%)/18 (32,6%); adenocarcinoma: 93%; Stage at diagnosis 4/3/2-1: 77%/16%/7%: BRAF V600E: 81%; co-mutations EGFR n = 2, ALK n = 2. Outcomes of stage IV (n = 44): first line treatment: chemotherapy: 61,9%, chemotherapy + radiotherapy : 9,5%, radiotherapy alone: 2.4%, Best supportive care (BSC): 11.9 %, anti BRAF: 14.2 %; response rate and PFS to first line treatment: 51.7% and 8.7 months (CI 6.4; 15.2), second line treatment (n = 21) : chemotherapy: 66.7%, anti BRAF 23.8%, BSC 9.5%; response rate and PFS to second line treatment: 35.3% and 4,8 months (CI 2,7;10,3); 2 years-OS: 58.5% (CI 45.8; 74.8). 17 pts received BRAF inhibitor. Outcome of stage IV BRAF harboring V600 E (n = 32) didn't showed any significant difference.
In this real world analysis, the majority of NSCLC patients with BRAF mutation were men, smokers and appears to have a better survival to NSCLC pts without oncogenic driver.
Clinical trial identification
EXPLORE GFPC 02-14 comité d'Ethique du CHU de Saint-Etienne Commission recherche de Terre d'éthique: IRBN 102016/CHUSTE
Legal entity responsible for the study
Clinical trial information: Supported by an academic grant from Lilly, Astra Zeneca, boehringer ingelheim
J.B. Auliac: In the last five years, honoraria for attending scientific meetings, speaking, organizing research or consulting, from Boehringer Ingelheim, Hoffman-Roche, Lilly and Pfizer. A. Vergnenegre: In the last five years, Honoraria for attending scientific meetings, speaking, organizing research or consulting, from Boehringer Ingelheim, Hoffman- Roche, Lilly. C. Chouaid: Honoraria for attending scientific meetings, speaking, organizing research or consulting, from Astra Zeneca, Boehringer Ingelheim, GlaxoSmithKline, Hoffman-la Roche, Sanofi Aventis, Lilly, Novartis and Amgen. All other authors have declared no conflicts of interest.