The effect of prognostic factors at baseline on the efficacy of trifluridine/tipiracil in patients with metastatic colorectal cancer: A Portuguese exploratory analysis.


Journal

Cancer treatment and research communications
ISSN: 2468-2942
Titre abrégé: Cancer Treat Res Commun
Pays: England
ID NLM: 101694651

Informations de publication

Date de publication:
2022
Historique:
received: 19 01 2022
revised: 03 02 2022
accepted: 04 02 2022
pubmed: 17 2 2022
medline: 18 5 2022
entrez: 16 2 2022
Statut: ppublish

Résumé

The RECOURSE trial supported trifluridine/tipiracil as a treatment option in metastatic colorectal cancer (mCRC). Subsequent analysis demonstrated that low tumour burden and indolent disease are good prognosis factors improving progression-free survival (PFS) and overall survival (OS). This study aimed to evaluate the impact of prognosis group in the OS, PFS and safety of trifluridine/tipiracil in patients with mCRC. Single-centre, retrospective, and observational study of patients with mCRC who started trifluridine/tipiracil between February 2018 and July 2019. Patients were divided into good prognosis characteristics (GPC) [low tumour burden (less than 3 metastasis site) and indolent disease (≥18 months from first metastasis diagnosis)] and poor prognostic characteristics (PPC) group [high tumour burden (3 or more metastasis sites) and/or aggressive disease (<18 months since the first metastasis diagnosis)]. Median age was 67 years (48-82), 67.3% of the patients were male, and 65.3% had stage IV disease at baseline. Overall, median OS was 7.5 months (95%CI:5.7-9.3). Twenty-two patients (44.9%) presented GPC and 29 (59.1%) had PPC. GPC patients had longer median OS [11.4 (95%CI:6.2-16.7)] versus 3.9 months [(95%CI: 3.3-4.6),p < 0.0001] and PFS [4.9 (95%CI:3.0-6.9) versus 2.6 months (95%CI:2.2-2.8),p < 0.0001]. These differences were more pronounced in GPC patients with no liver metastasis. Grade ≥3 adverse events incidence didn't vary between GPC and PPC subgroups. Our study validates the improved trifluridine/tipiracil efficacy in patients with GPC in comparison with PPC while maintaining a well-tolerated safety profile. Indolent disease, low tumour burden and the absence of liver metastasis were shown to be good prognosis factors influencing sustained response to trifluridine/tipiracil.

Sections du résumé

BACKGROUND
The RECOURSE trial supported trifluridine/tipiracil as a treatment option in metastatic colorectal cancer (mCRC). Subsequent analysis demonstrated that low tumour burden and indolent disease are good prognosis factors improving progression-free survival (PFS) and overall survival (OS). This study aimed to evaluate the impact of prognosis group in the OS, PFS and safety of trifluridine/tipiracil in patients with mCRC.
METHODS
Single-centre, retrospective, and observational study of patients with mCRC who started trifluridine/tipiracil between February 2018 and July 2019. Patients were divided into good prognosis characteristics (GPC) [low tumour burden (less than 3 metastasis site) and indolent disease (≥18 months from first metastasis diagnosis)] and poor prognostic characteristics (PPC) group [high tumour burden (3 or more metastasis sites) and/or aggressive disease (<18 months since the first metastasis diagnosis)].
RESULTS
Median age was 67 years (48-82), 67.3% of the patients were male, and 65.3% had stage IV disease at baseline. Overall, median OS was 7.5 months (95%CI:5.7-9.3). Twenty-two patients (44.9%) presented GPC and 29 (59.1%) had PPC. GPC patients had longer median OS [11.4 (95%CI:6.2-16.7)] versus 3.9 months [(95%CI: 3.3-4.6),p < 0.0001] and PFS [4.9 (95%CI:3.0-6.9) versus 2.6 months (95%CI:2.2-2.8),p < 0.0001]. These differences were more pronounced in GPC patients with no liver metastasis. Grade ≥3 adverse events incidence didn't vary between GPC and PPC subgroups.
CONCLUSION
Our study validates the improved trifluridine/tipiracil efficacy in patients with GPC in comparison with PPC while maintaining a well-tolerated safety profile. Indolent disease, low tumour burden and the absence of liver metastasis were shown to be good prognosis factors influencing sustained response to trifluridine/tipiracil.

Identifiants

pubmed: 35172243
pii: S2468-2942(22)00022-3
doi: 10.1016/j.ctarc.2022.100531
pii:
doi:

Substances chimiques

Pyrrolidines 0
Uracil 56HH86ZVCT
tipiracil NGO10K751P
Thymine QR26YLT7LT
Trifluridine RMW9V5RW38

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

100531

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

M João de Sousa (MJ)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal. Electronic address: mariasousa2@campus.ul.pt.

Inês Gomes (I)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Tatiana Cunha Pereira (TC)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Joana Magalhães (J)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Raquel Basto (R)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Judy Paulo (J)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Paula Jacinto (P)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Nuno Bonito (N)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

Gabriela Sousa (G)

Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.

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Classifications MeSH