Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jan 24, 2025; 16(1): 93670
Published online Jan 24, 2025. doi: 10.5306/wjco.v16.i1.93670
Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine
Jiang-Yu Bian, Yu-Fang Feng, Wen-Ting He, Tong Zhang
Jiang-Yu Bian, Tong Zhang, Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
Yu-Fang Feng, Department of Oncology, The Fourth Clinical Medical College of Xinjiang Medical University, Urumqi‎ 830001, China
Wen-Ting He, Department of Oncology, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi‎ 830001, China
Co-corresponding authors: Wen-Ting He and Tong Zhang.
Author contributions: Guarantor of integrity of entire study, manuscript preparation, manuscript definition of intellectual content, and manuscript final version approval were conducted by Zhang T; Study concepts, study design, and clinical studies were conducted by Zhang T and He WT; Literature research, data acquisition, and manuscript editing were conducted by Bian JY and Feng YF; Data analysis/interpretation was conducted by Zhang T and Bian JY; Statistical analysis and manuscript revision/review were conducted by He WT; Since this study includes two research centers in Beijing and Xinjiang, and the research workload of the two centers is balanced, He WT and Zhang T are listed as co-corresponding authors.
Supported by National Natural Science Foundation of China, No. 82174461; Hospital Capability Enhancement Project of Xiyuan Hospital, CACMS, No. XYZX0201-22; and Technology Innovation Project of China Academy of Chinese Medical Sciences; No. CI2021A01811.
Institutional review board statement: This study was approved by the Xiyuan Hospital, China Academy of Chinese Medical Sciences.
Informed consent statement: After review by the Ethics Committee, the informed consent was waived.
Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tong Zhang, MD, Associate Chief Physician, Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, No. 1 Xiyuan Playground, Haidian District, Beijing 100091, China. ashtray7654@126.com
Received: March 3, 2024
Revised: September 4, 2024
Accepted: October 11, 2024
Published online: January 24, 2025
Processing time: 240 Days and 20 Hours
Abstract
BACKGROUND

Patients with BRAF V600E mutant metastatic colorectal cancer (mCRC) have a low incidence rate, poor biological activity, suboptimal response to conventional treatments, and a poor prognosis. In the previous cohort study on mCRC conducted by our team, it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival (OS) of patients with colorectal cancer. Therefore, we further explored the survival benefits in the population with BRAF V600E mutant mCRC.

AIM

To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.

METHODS

A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022. The patients were divided into two cohorts.

RESULTS

A total of 34 cases were included, with 23 in Chinese-Western medicine cohort (cohort A) and 11 in Western medicine cohort (cohort B). The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B, with a statistically significant difference (P = 0.038, hazard ratio = 0.46). The 1-3-year survival rates were 95.65% (22/23), 39.13% (9/23), and 26.09% (6/23) in cohort A, and 63.64% (7/11), 18.18% (2/11), and 9.09% (1/11) in cohort B, respectively. Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon, liver metastasis, chemotherapy, and first-line treatment subgroups (P < 0.05).

CONCLUSION

Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer, with more pronounced benefits observed in patients with right colon involvement, liver metastasis, combined chemotherapy, and first-line treatment.

Keywords: Metastatic colorectal cancer; BRAF V600E mutation; Integrated Chinese and Western medicine; Cohort study

Core Tip: Patients with BRAF V600E mutant metastatic colorectal cancer (mCRC) have a much lower median overall survival than patients without BRAF V600E mutations. This study employed a retrospective cohort design and confirmed that in the real world, compared to chemotherapy and/or targeted therapy, combined treatment with integrated Chinese and Western medicine significantly extended overall survival and reduced the risk of death in BRAF V600E mutated mCRC patients, while being more effective in patients involving right colon, liver metastases, combined chemotherapy, and first-line therapy.