title: The rare BRAF VK600-601E mutation as a possible indicator of poor prognosis in rectal carcinoma – a report of a case.
abstract: BACKGROUND
  The BRAF V600E mutation is reportedly associated with inferior survival among colon cancer patients. Here we report a patient with rectal cancer who carried the novel BRAF mutation VK600-601E, which has analogous molecular functions to those of the conventional BRAF mutation V600E, and may have potential as a prognostic marker for colorectal cancer (CRC).
  
  
  METHODS
  The present 65-year-old male patient was diagnosed with recurrent rectal adenocarcinoma (stage II by AJCC TNM staging 7th edition) 14 months after surgery and was treated with modified FOLFOX6 (fluorouracil, leucovorin, and oxaliplatin), radiation, and FOLFIRI (fluorouracil, leucovorin, and irinotecan). The tumor progressed before further treatment could be initiated, resulting in death after 15 months. This survival period was similar to the median overall survival among patients with metastatic CRC and BRAF mutations who were treated with the FOLFIRI regimen with or without cetuximab.
  
  
  CONCLUSIONS
  Thus, the BRAF VK600-601E mutation may lead to an aggressive clinical course in CRC patients suffering from rapid progression and potential resistance to multiple therapeutic modalities.
authors: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. yoshikomori1@gmail.com.
authors: Yoshiko
authors: Y
authors: Mori
authors: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. takeshin@cc.okayama-u.ac.jp.
authors: Takeshi
authors: T
authors: Nagasaka
authors: Cancer Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute City, Aichi, 480-1195, Japan. mishima01@sa2.so-net.ne.jp.
authors: Hideyuki
authors: H
authors: Mishima
authors: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. y.umeda@d9.dion.ne.jp.
authors: Yuzo
authors: Y
authors: Umeda
authors: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. ryo_inada@hotmail.com.
authors: Ryo
authors: R
authors: Inada
authors: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. kishipon777@yahoo.co.jp.
authors: Hiroyuki
authors: H
authors: Kishimoto
authors: Center of Gastrointestinal Research; and Center for Epigenomics, Cancer Prevention and Cancer Genomics, Baylor Research Institute and Charles A. Sammons Cancer Center, Baylor University Medical Center, 3500 Gaston Avenue, Suite H-250, Dallas, TX, 75246, USA. ajayg@baylorhealth.edu.
authors: Ajay
authors: A
authors: Goel
authors: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. toshi_f@md.okayama-u.ac.jp.
authors: Toshiyoshi
authors: T
authors: Fujiwara
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics; D000368:Aged; D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000235:genetics; D006801:Humans; D008297:Male; D009154:Mutation; D011379:Prognosis; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics*; D012008:Recurrence
chemical_list: D014408:Biomarkers, Tumor; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
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