Advances in the therapy of BRAF^V600E metastatic colorectal cancer

Introduction: BRAF^V600E metastatic colorectal cancer (CRC) is an aggressive tumor subset with an approximate 8% incidence. In these patients, standard chemotherapy has limited efficacy, and the recent development of novel-targeted treatment regimens may significantly improve clinical outcome. Area covered: This review provides an overview of available data regarding advances in the first–line treatment of BRAF^V600E metastatic CRC including patient tumors with microsatellite instability. The implications of BRAF^V600E in earlier stage CRC are also discussed. Expert opinion: Recently, significant progress has been achieved in improving tumor response rates using a novel-targeted regimen in patients with BRAF^V600E metastatic CRC. The implications of BRAF^V600E in non-metastatic CRC are also becoming more evident and remains an area of ongoing investigation. The majority of CRCs with microsatellite instability high are sporadic and frequently harbor BRAF^V600E. All patients with microsatellite instability high metastatic CRCs, irrespective of BRAF^V600E, are candidates for immune checkpoint inhibitors. The optimal sequencing of treatment regimens for patients with BRAF^V600E metastatic CRCs is an important area for future research.