Severe Cardiac Dysfunction in Colon Cancer Patients Undergoing Triple Therapy

Strategic Insights -

A new report published by researchers at Nagoya City University Graduate School of Medical Sciences highlights the risk of cardiac dysfunction in patients with BRAF-mutated colorectal cancer receiving triple therapy consisting of encorafenib, binimetinib, and cetuximab. The study emphasizes the importance of early recognition and management of this adverse event to ensure patient safety and effective treatment.

Key Takeaways:

  • Approximately 5% of Japanese patients with colorectal cancer who receive BRAF-targeted triplet therapy develop cardiac dysfunction, primarily attributed to MEKi.
  • The clinical course of cardiac dysfunction remains unclear, and early recognition is crucial for effective management.
  • A 70-year-old Japanese man with BRAF-mutated colon cancer experienced severe symptomatic cardiac dysfunction while undergoing triplet therapy, which was effectively managed with cardiotropic medications and discontinuation of binimetinib.
  • The patient's cardiac function improved rapidly, and treatment was resumed as doublet therapy without binimetinib, with no recurrence of cardiac dysfunction symptoms observed.
  • Regular echocardiographic surveillance with an interval shorter than 4 months is essential in patients receiving BRAF-targeted therapy to monitor for cardiac dysfunction.
  • Multidisciplinary monitoring is critical for early recognition and effective management of cardiac dysfunction in patients undergoing triple therapy.

Statistics:

  • 5% of Japanese patients with colorectal cancer who receive BRAF-targeted triplet therapy experience cardiac dysfunction (Source: Nagoya City University Graduate School of Medical Sciences).
  • 70% of the patient's left ventricular ejection fraction (LVEF) declined to 33% within 1 week of treatment interruption (Source: Nagoya City University Graduate School of Medical Sciences).
  • The patient's general condition improved rapidly after initiation of cardiotropic medications and discontinuation of binimetinib, and treatment was resumed as doublet therapy without binimetinib (Source: Nagoya City University Graduate School of Medical Sciences).
  • The median progression-free survival reported in the phase III BEACON-CRC trial was exceeded by the patient in this case report (Source: BEACON-CRC trial).

Sources:

  • Severe symptomatic cardiac dysfunction in a patient with BRAF V600E-mutated metastatic colorectal cancer treated with encorafenib, binimetinib, and cetuximab: a case report. Journal of Pharmaceutical Health Care and Sciences, 2025;11(1):80.
  • Researchers at Nagoya City University Graduate School of Medical Sciences Target Colon Cancer (Severe symptomatic cardiac dysfunction in a patient with BRAF V600E-mutated metastatic colorectal cancer treated with encorafenib, binimetinib, and ...). Immunotherapy Weekly. September 17, 2025; p 879.