A validated prognostic classifier for V600E BRAF-mutated metastatic colorectal cancer: the 'BRAF BeCool' study.

Fotios Loupakis, Rossana Intini, Chiara Cremolini, Armando Orlandi, Andrea Sartore-Bianchi, Filippo Pietrantonio, Nicoletta Pella, Andrea Spallanzani, Emanuela Dell'Aquila, Mario Scartozzi, Emmanuele De Luca, Lorenza Rimassa, Vincenzo Formica, Francesco Leone, Lorenzo Calvetti, Giuseppe Aprile, Lorenzo Antonuzzo, Federica Urbano, Hans Prenen, Francesca NegriSamantha Di Donato, Pasquale Buonandi, Gianluca Tomasello, Antonio Avallone, Fable Zustovich, Roberto Moretto, Carlotta Antoniotti, Lisa Salvatore, Maria Alessandra Calegari, Salvatore Siena, Federica Morano, Elena Ongaro, Stefano Cascinu, Daniele Santini, Pina Ziranu, Marta Schirripa, Federica Buggin, Alessandra Anna Prete, Ilaria Depetris, Paola Biason, Sara Lonardi, Vittorina Zagonel, Matteo Fassan, Massimo Di Maio

Research output: Contribution to journalArticlepeer-review


Despite the well-known negative prognostic value of the BRAF mutation in patients with metastatic colorectal cancer (mCRC), its outcome is quite heterogeneous, and the basis for this prognostic heterogeneity should be better defined. Two large retrospective series of BRAF-mutated mCRC from 22 institutions served as an exploratory and validation set to develop a prognostic score. The model was internally and externally validated. A total of 395 BRAF-mutated mCRCs were included in the exploratory set. Performance status, CA19.9, lactate dehydrogenase, neutrophil/lymphocyte ratio, grading and liver, lung and nodal involvement emerged as independent prognostic factors for overall survival (OS). Two different scoring systems were built: a 'complete' score (0-16) including all significant covariates and a 'simplified' score (0-9), based only on clinicopathological covariates, and excluding laboratory values. Adopting the complete score, proportions of patients with a low (0-4), intermediate (5-8) and high (9-16) score were 44.7%, 42.6% and 12.6%, respectively. The median OS was 29.6, 15.5 (hazard ratio [HR] for intermediate vs low risk: 2.16, 95% confidence interval [CI]: 1.44-3.22, p 
Original languageUndefined/Unknown
Pages (from-to)121-130
Number of pages10
JournalEuropean Journal of Cancer
Publication statusPublished - Sep 1 2019


  • (V600E)BRAF
  • Colorectal cancer
  • Metastases
  • Prognostic markers
  • Scoring system

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