Another very important biochemical or molecular mutation that we need to know about in colorectal stage four metastatic cancer is BRAF. Unfortunately, a mutation in BRAF is generally representative of a more aggressive tumor. Right-sided colon tumors are usually more likely to be BRAF positive than left-sided colorectal cancers. If you are BRAF positive for a mutation, it does open you up to some targeted therapies which are directed at BRAF as well as what’s called a MEK inhibitor. Sometimes you can use these both together, you can exchange them around, and with all of molecular mutations and targeted mutations, you can use them as adjuncts with your cytotoxic chemotherapy. But the BRAF status is important because it generally represents a more aggressive tumor type. You have therapies that can attack BRAF, again, BRAF inhibitors as well as MEK inhibitors, also because they’re more aggressive, BRAF positive or mutated tumors have a more likelihood to go to the perineum, to spread, meaning that pool where all of your intestines float around in, BRAF mutated colorectal cancers seem to have metastasis into that perineum, which can present eventually as constipation or total blockage due to the cancer a budding on the outside of the intestine.