BREAKWATER Cohort 3 at #GI26 👀 Presented by @skopetz @ASCO Important context first. This is unlikely to be practice changing in the US, where we generally favor upfront FOLFOX. But in Europe and Canada, FOLFIRI is used upfront a meaningful amount of the time, so these data matter 🌍 BREAKWATER Cohort 3 1L BRAF V600E–mutant mCRC, n=147 FOLFIRI plus encorafenib and cetuximab vs FOLFIRI control What we saw: 1️⃣ ORR 64% vs 39% 2️⃣ OS trend favoring EC plus FOLFIRI HR 0.49 (95% CI 0.24 to 1.03), median OS not reached 3️⃣ Results look very consistent with what we saw in the FOLFOX cohort 4️⃣ No new safety signals Takeaway: Not a paradigm shift in the US, but reassuring and useful data, especially for 🇨🇦 and parts of 🇪🇺 where FOLFIRI is commonly used upfront. Always good to have more validated options for BRAF-mutant disease. Lingering question for me: If you start EC with FOLFIRI, do you continue EC at progression the same way many of us do after FOLFOX? Would love to see data addressing that. At least we know toxicity is ok now. #GI26 @OncoAlert @TheGutOncLabi