Cancer Treatment Today

ZELBORAF® is indicated for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E mutation as detected by an FDA-approved test. THe proposed use is off-label.

The BRAF V600E mutation is present in approximately 15% of patients with early-stage CRC and 6% of those with metastatic CRC. The prognosis of patients who have metastatic disease with the BRAF V600E mutation is very poor; the length of their survival is approximately half that of patients who have metastatic disease without the mutation. BRAF inhibitor monotherapy has limited efficacy, in contrast to metastatic melanoma. NCCN in 2018 addded (COL-D/REC-E) 9 of 10:

Irinotecan + cetuximab + vemurafenib (BRAF V600E mutation positive): Irinotecan 180 mg/m2 IV every 14 days and cetuximab 500 mg/m2 IV every 14 days with vemurafenib 960 mg PO twice daily (reference added to COL-D/REC-E 10 of 10)

Irinotecan + panitumumab + vemurafenib (BRAF V600E mutation positive): Irinotecan 180 mg/m2 IV every 14 days and panitumumab 6 mg/kg IV over 60 minutes every 2 weeks with vemurafenib 960 mg PO twice daily.

Single agent Zelboraf is not well-supported adn not pertucalry, if at all effective in studies.

Korphaisarn K, Kopetz S. BRAF-Directed Therapy in Metastatic Colorectal Cancer. Cancer J. 2016;22(3):175-178. doi:10.1097/PPO.0000000000000189

Zelboraf Prescribing Information 2020