Impact of tumour growth rate during preceding treatment on tumour response to regorafenib or trifluridine/tipiracil in refractory metastatic colorectal cancer.

BACKGROUND

Although regorafenib (REG) and trifluridine/tipiracil (FTD/TPI) have been recognised as standard treatments in metastatic colorectal cancer (mCRC), the best option remains unclear. Pretreatment tumour growth rate (TGR) is associated with radiotherapeutic efficacy in laryngeal cancer. However, no reports are available on the association between TGR during preceding treatment and the efficacy of REG or FTD/TPI.

PATIENTS AND METHODS

We retrospectively analysed the data of consecutive mCRC patients treated with REG or FTD/TPI and classified them into slow-growing or rapid-growing (SG or RG) groups according to TGR and emergence of new lesion (NL+) or their absence (NL-) during preceding treatment period [SG: NL- with low TGR (<0.33%/day); RG: NL+ or high TGR (≥0.33%/day)].

RESULTS

A total of 244 patients (RG/SG, 133/111; REG/FTD/TPI, 132/112) were eligible. The RG proportion with a long duration from first-line chemotherapy and the SG proportion with elevated alkaline phosphatase were higher in REG, whereas the SG proportion with performance status 2 was higher in FTD/TPI. The disease control rates (DCRs) were similar between REG and FTD/TPI (24%/30%; OR: 0.74; p=0.44; adjusted OR: 0.73; p=0.47) in the RG, whereas the DCR was significantly higher for FTD/TPI than for REG (47%/26%; OR: 2.56; p=0.029; adjusted OR: 3.38; p=0.01) in the SG.

CONCLUSIONS

TGR and NL during preceding treatment may be helpful for drug selection in refractory mCRC patients to be treated with REG or FTD/TPI. However, further studies are needed to confirm the value of TGR for drug selection.

Informations de copyright

© Author (s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.

Déclaration de conflit d'intérêts

Competing interests: The authors declare the following conflicts: ToM has received honoraria from Takeda, Chugai, Merck Serono, Taiho, Bayer, Lilly Japan, Yakult Honsha and Sanofi and has received research funding from Yakult Honsha, MSD, Daiichi Sankyo and Ono; Hiroya Taniguchi has received honoraria from Takeda, Chugai, Merck Serono, Taiho, Bayer, Lilly Japan and Yakult Honsha, Sanofi; TK has received honoraria from Taiho; YK has received honoraria from Taiho, Daiichi Sankyo, Takeda, Chugai, Merck Biopharma and Eli Lilly Japan; SK has received honoraria from Chugai, Bristol-Myers Squibb, Ono, Merck KGaA, Bayer, Lilly and Yakult Honsha, and research funding from Taiho, Bristol-Myers Squibb, Ono, Lilly and MSD; MT has received honoraria from EA pharma and Olympus and has received research funding from EA pharma; HN has received honoraria from Takeda, Chugai, Ono, Bayer and Lilly Japan; SY has received honoraria from Takeda, Chugai, Bristol-Myers Squibb, Ono, Merck Serono, Taiho, Bayer, Lilly Japan, Yakult Honsha and Sanofi; KM has received honoraria from Takeda, Chugai, Taiho, Bayer, Eli Lilly, Ono, Sanofi and Bristol-Myers Squibb and has received research funding from Parexel International, Merck Serono, MSD, Mediscience Planning, Pfizer, Daiichi Sankyo, Sanofi, Shionog, Sumitomo Dainippon Pharma, Solasia Pharma and Takeda; YK has received honoraria Takeda, Chugai, Bristol-Myers Squibb, Ono, Merck Biopharma, Taiho, Bayer, Lilly, Yakult Honsha, Sanofi, Nipro, Moroo, Asahi Kasei, Mitsubishi Tanabe, Otsuka, Medical Review and Shiseido and has received research funding from MSD, Daiichi Sankyo, NanoCarrier, Eisai, Sysmex, Shionogi, IQVIA, Parexel International, Astellas, Mediscience, Sumitomo Dainippon, A2 Healthcare, Ono, Taiho, Bayer, Yakult Honsha and Sanofi; KY has received honoraria from Takeda, Chugai, Daiichi Sankyo, Bristol-Myers Squibb, Ono, Merck Serono, Taiho, Bayer, Lilly, Yakult Honsha, Sanofi and MSD and has received research funding from Taiho.