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ASCO 2025 | ASCO 2025 colorectal cancer updates: BREAKWATER & ATOMIC
Heinz-Josef Lenz, MD, FACP, University of Southern California, Los Angeles, CA, gives an overview of the results of the BREAKWATER trial (NCT04607421), which demonstrates a promising response rate and median survival in patients with BRAF V600E-mutant metastatic colorectal cancer being treated with first-line encorafenib plus cetuximab and chemotherapy in BRAF V600E-mutant metastatic colorectal cancer. The trial’s results highlight the importance of using the best treatment at any given time. Prof. Lenz also comments the potential for liquid biopsies to guide treatment and the ATOMIC trial (NCT02912559), which may show that an adjuvant treatment with FOLFOX and an immune checkpoint inhibitor is more successful than FOLFOX alone in MSI-high tumors. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
I think there are two particular areas. One is BREAKWATER clearly demonstrating that the addition of nivolumab, cetuximab with FOLFOX has an incredible response rate and a median survival of 30 months is unheard of because BRAF mutant or BRAF V600E mutant usually have a median survival of 12-14 months. So this is now 30 months. I think this data really suggests similar to the immunotherapy trials that when you have a targeted agent, you use it at the time of diagnosis...
I think there are two particular areas. One is BREAKWATER clearly demonstrating that the addition of nivolumab, cetuximab with FOLFOX has an incredible response rate and a median survival of 30 months is unheard of because BRAF mutant or BRAF V600E mutant usually have a median survival of 12-14 months. So this is now 30 months. I think this data really suggests similar to the immunotherapy trials that when you have a targeted agent, you use it at the time of diagnosis. You cannot easily make it up later. So always use the best treatment at any given time. I think the second interesting aspect is will we see the integration of more liquid biopsy for particular minimal residual disease in our clinical setting and can they guide us in treatment? I think the data are not all consistent, so this will be very important. But tomorrow we hear ATOMIC, which would be the first clinical trial showing that an adjuvant treatment with FOLFOX with an immune checkpoint inhibitor may be more successful than FOLFOX alone in MSI-high tumors because in adjuvant treatment, no treatment has changed for the last 20 years. So we are very excited. The fact it is in the plenary session, we assume it is a positive trial. So we are very excited about that. Thank you.
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