The BRAVE is a phase II clinical trial aimed at evaluating the efficacy of the combination therapy of encorafenib, cetuximab, and bevacizumab in patients with metastatic colorectal cancer (CRC) harboring the BRAF-V600E mutation. This mutation is present in about 8-10% of CRC cases and is associated with poor prognosis and limited treatment options. The rationale behind this trial stems from preclinical studies suggesting that the overexpression and activation of vascular endothelial growth factor A (VEGFA) may contribute to resistance to BRAF inhibitors (BRAFi) in CRC. Thus, the trial hypothesizes that adding bevacizumab, an anti-angiogenic agent targeting VEGFA, to the combination of encorafenib and cetuximab may delay acquired resistance, leading to improved progression-free survival. The primary objective of the BRAVE is to evaluate the antitumor activity of the encorafenib-cetuximab-bevacizumab combination in patients who have experienced disease progression after one or two chemotherapy regimens for BRAF V600E-mutant metastatic CRC. This activity will be assessed based on the confirmed progression-free survival rate according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria.
Study Design: The study adopts a multicenter, open-label, phase II design. Patients with metastatic CRC harboring the BRAF-V600E mutation, who have experienced disease progression after one or two prior chemotherapy regimens, are eligible for enrollment. The treatment regimen consists of daily oral encorafenib (300 mg), biweekly intravenous cetuximab (500 mg/m2), and biweekly intravenous bevacizumab (5 mg/kg). Treatment will be administered in 28-day cycles until disease progression, unacceptable toxicity, consent withdrawal, initiation of other anticancer therapy, or death. Secondary Objectives: Secondary objectives include evaluating the safety and tolerability of the combination therapy, assessing objective response rate, time to response, duration of response, overall survival, and patient-reported outcomes. Exploratory objectives involve evaluating potential biomarkers predictive of treatment response and resistance, as well as generating functional models to assess novel drug combinations targeting resistance mechanisms.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
94
Encorafenib is administered orally at a daily dose of 300 mg, typically in the form of four 75 mg capsules taken together.
Cetuximab is administered intravenously every two weeks at a dose of 500 mg/m².
Bevacizumab is administered intravenously every two weeks at a dose of 5 mg/kg.
Vall d'Hebron Hospital
Barcelona, Spain
RECRUITINGProgression-Free Survival (PFS)
PFS will be evaluated by local radiologist/investigator assessment per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 (v1.1). It refers to the duration from the start of treatment until disease progression or death due to any cause.
Time frame: Until disease progression, typically within a follow-up period of approximately 5 years.
Objective Response Rate (ORR)
ORR will be determined as the proportion of patients achieving a complete response (CR) or partial response (PR) according to RECIST v1.1 criteria.
Time frame: Throughout the study duration, that it will take 5 years
Duration of Response (DOR)
DOR is defined as the duration from the first radiographic evidence of response to the earliest documented disease progression or death due to underlying disease.
Time frame: Until disease progression, typically within a follow-up period of approximately 5 years.
Disease Control Rate (DCR)
The proportion of patients who achieve a complete response, partial response, or stable disease as the best overall response to treatment.
Time frame: Throughout the study duration, that it will take 5 years
Electrocardiogram (ECG) Changes
This outcome measure assesses changes in electrocardiogram (ECG) parameters in participants receiving treatment with encorafenib in combination with cetuximab and bevacizumab, as well as up to 30 ± 2 days after the last dose. ECG recordings will be analyzed for parameters such as QT interval duration, presence of arrhythmias, and other relevant ECG changes.
Time frame: During treatment (until disease progression) and up to 30 ± 2 days after the last dose.
Incidence and Severity of Adverse Events
This outcome measure assesses the occurrence and severity of adverse events experienced by participants during treatment with encorafenib in combination with cetuximab and bevacizumab, as well as up to 30 ± 2 days after the last dose. Adverse events will be categorized and graded according to standardized criteria (e.g., CTCAE version 5.0).
Time frame: Until disease progression, typically within a follow-up period of approximately 5 years.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.