Dr. Marshall on the Importance of Testing for BRAF Mutations in mCRC

John L. Marshall, MD
Published: Monday, Feb 12, 2018



John L. Marshall, MD, chief, Division of Hematology/Oncology, Medstar Georgetown University Hospital director, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, discusses the specificity now required in the treatment of patients with metastatic colorectal cancer (mCRC).

As colon cancer has been subdivided into different groups, each group’s characteristics have been coming to the forefront. BRAF-mutated tumors are known to behave more aggressively and have poor prognosis. However, Marshall notes that was true of HER2-positive breast cancer, as well. It wasn’t until new therapies were made to target HER2 that it became manageable.

Though these targeted agents are not as developed for BRAF mutations, ongoing clinical trials are demonstrating that combination regimens do better in BRAF mutations. The current standard of care does not include inclusive BRAF testing, but as treatment becomes increasingly dependent on tumor type, Marshall advises physicians to test all of their patients for BRAF mutations in addition to RAS and microsatellite instability-high tumors.


John L. Marshall, MD, chief, Division of Hematology/Oncology, Medstar Georgetown University Hospital director, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, discusses the specificity now required in the treatment of patients with metastatic colorectal cancer (mCRC).

As colon cancer has been subdivided into different groups, each group’s characteristics have been coming to the forefront. BRAF-mutated tumors are known to behave more aggressively and have poor prognosis. However, Marshall notes that was true of HER2-positive breast cancer, as well. It wasn’t until new therapies were made to target HER2 that it became manageable.

Though these targeted agents are not as developed for BRAF mutations, ongoing clinical trials are demonstrating that combination regimens do better in BRAF mutations. The current standard of care does not include inclusive BRAF testing, but as treatment becomes increasingly dependent on tumor type, Marshall advises physicians to test all of their patients for BRAF mutations in addition to RAS and microsatellite instability-high tumors.



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