Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Medical Oncology and General Medicine, IMS Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
PLoS One. 2022 Jun 2;17(6):e0269115. doi: 10.1371/journal.pone.0269115. eCollection 2022.
Trifluridine/tipiracil (TFTD), with or without bevacizumab (Bev), and regorafenib are salvage chemotherapy options for metastatic colorectal cancer (mCRC). Here, we examined the influence of precedent drug on the efficacy of subsequent drug.
The subjects were patients with mCRC who received salvage chemotherapy with TFTD (with/without Bev) followed by regorafenib (TFTD→Rego group/TFTD+Bev→Rego group), or reverse sequence (Rego→TFTD group) at the National Cancer Center Hospital between November 2013 and December 2020. The overall survival (OS), progression-free survival (PFS), disease control rate (DCR), tumor growth rate (TGR), and tumor growth kinetics (TGK) in the first evaluation were assessed in the three groups.
A total of 69 patients, including 27 in the TFTD→Rego group, 13 in the TFTD+Bev→Rego group, and 29 in the Rego→TFTD group, were identified. There were no significant differences in the OS among the three groups, and in the PFS and DCR between the precedent and subsequent therapies in any of the groups. The median TGR (%/month) and TGK (mm/month) in the precedent→subsequent therapy were 50.9→32.7 (p = 0.044) and 8.76→7.79 in the TFTD→Rego group, 25.4→36.1 and 7.49→9.92 in the TFTD+Bev→Rego group, and 40.8→24.4 (p = 0.027) and 8.02→7.20 in the Rego→TFTD group, respectively.
In crossover use of TFTD with/without Bev and regorafenib, both agents showed similar efficacy in terms of the conventional parameters, but the differences observed in the TGR and TGK might suggest some influence of prior regorafenib treatment on the efficacy of subsequent TFTD therapy, and vice versa.
替氟尿苷/盐酸拓扑替康（TFTD）联合或不联合贝伐珠单抗（Bev）以及瑞戈非尼是转移性结直肠癌（mCRC）的挽救化疗选择。在此，我们研究了先前药物对后续药物疗效的影响。
本研究纳入 2013 年 11 月至 2020 年 12 月期间在日本国立癌症研究中心接受 TFTD（联合或不联合 Bev）后继以瑞戈非尼（TFTD→Rego 组/TFTD+Bev→Rego 组）或相反顺序（Rego→TFTD 组）挽救化疗的 mCRC 患者。评估三组患者的总生存期（OS）、无进展生存期（PFS）、疾病控制率（DCR）、肿瘤生长率（TGR）和肿瘤生长动力学（TGK）。
共纳入 69 例患者，其中 TFTD→Rego 组 27 例，TFTD+Bev→Rego 组 13 例，Rego→TFTD 组 29 例。三组患者的 OS 无显著差异，且各组中先前和后续治疗的 PFS 和 DCR 也无显著差异。TFTD→Rego 组中，先前→后续治疗的中位 TGR（%/月）和 TGK（mm/月）分别为 50.9→32.7（p=0.044），TFTD+Bev→Rego 组分别为 25.4→36.1 和 7.49→9.92，Rego→TFTD 组分别为 40.8→24.4（p=0.027）和 8.02→7.20。
TFTD 联合或不联合 Bev 与瑞戈非尼交叉使用时，两种药物在常规参数方面的疗效相似，但 TGR 和 TGK 的差异可能提示先前接受瑞戈非尼治疗对后续 TFTD 治疗疗效的影响，反之亦然。
