St Luke's Cancer Centre, Royal Surrey NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK.
Surrey Clinical Trials Unit, University of Surrey, Egerton Road, Guildford GU2 7XP, UK.
Curr Oncol. 2021 Jun 18;28(3):2260-2269. doi: 10.3390/curroncol28030208.
In the UK, Trifluridine-tipiracil (Lonsurf) is used to treat metastatic colorectal cancer in the third-line setting, after prior exposure to fluoropyrimidine-based regimes. Current data on the real-world use of Lonsurf lack long-term follow-up data. A retrospective evaluation of patients receiving Lonsurf at our Cancer Centre in 2016-2017 was performed, all with a minimum of two-year follow-up. Fifty-six patients were included in the review. The median number of cycles of Lonsurf administered was 3. Median follow-up was 6.0 months, with all patients deceased at the time of analysis. Median progression-free survival (PFS) was 3.2 months, and overall survival (OS) was 5.8 months. The median interval from Lonsurf discontinuation to death was two months, but seven patients received further systemic treatment and median OS gained was 12 months. Lonsurf offered a slightly better PFS but inferior OS to that of the RECOURSE trial, with PFS similar to real-world data previously presented. Interestingly, 12.5% had a PFS > 9 months, and this cohort had primarily left-sided and RAS wild-type disease. A subset received further systemic treatment on Lonsurf discontinuation with good additional OS benefit. Lonsurf may alter the course of disease for a subset of patients, and further treatment on progression can be considered in carefully selected patients.
在英国，曲氟尿苷替匹嘧啶（Lonsurf）在氟嘧啶类方案治疗后，用于转移性结直肠癌的三线治疗。目前关于 Lonsurf 在真实世界应用的数据缺乏长期随访数据。对我们癌症中心 2016-2017 年接受 Lonsurf 治疗的患者进行了回顾性评估，所有患者均有至少两年的随访。共纳入 56 例患者。Lonsurf 治疗的中位周期数为 3 个。中位随访时间为 6.0 个月，所有患者在分析时均已死亡。中位无进展生存期（PFS）为 3.2 个月，总生存期（OS）为 5.8 个月。从 Lonsurf 停药到死亡的中位间隔为 2 个月，但有 7 例患者接受了进一步的系统治疗，中位 OS 延长了 12 个月。Lonsurf 提供了稍长的 PFS 但较差的 OS，与 RECURSE 试验相似，PFS 与之前报告的真实世界数据相似。有趣的是，12.5%的患者 PFS > 9 个月，这部分患者主要患有左侧和 RAS 野生型疾病。亚组患者在 Lonsurf 停药后接受了进一步的系统治疗，具有良好的额外 OS 获益。Lonsurf 可能会改变一部分患者的疾病进程，对于精心选择的患者，可以考虑在疾病进展时进行进一步的治疗。
