Praxis Dr. Michl, Specialists for Hematology and Oncology, Munich, Germany.
RADIOLOGIE München, Specialists for Radiology, Munich, Germany.
Chemotherapy. 2024;69(1):27-34. doi: 10.1159/000531525. Epub 2023 Jun 19.
Trifluridine/tipiracil is approved for the use in later or last-line setting in previously treated metastatic colorectal cancer (mCRC) patients who progressed on standard anti-tumor drugs including 5-fluorouracil (5-FU), irinotecan, oxaliplatin, anti-VEGF and anti-EGFR antibodies, or who are not considered candidates for those standard therapies. In this report, we describe a 67-year-old male patient with KRAS-mutated mCRC and metachronous liver and lung metastasis who failed prior 5-FU- and irinotecan-containing regimens, but then showed long-term disease control for 31 months on single-agent trifluridine/tipiracil given as second-line treatment. According to our experience, trifluridine/tipiracil is a feasible and effective treatment option in earlier but not necessarily last-line therapy in mCRC patients who are not considered candidates for doublet or triplet chemotherapy. Besides its efficacy, it is associated with maintained quality of life and a manageable toxicity profile. Considering increasing age of mCRC patients and their wish for maintaining an independent lifestyle, further research on the use of trifluridine/tipiracil in earlier lines of systemic mCRC therapy is warranted.
替拉鲁肽/曲氟尿苷获批用于既往接受过包括氟尿嘧啶(5-FU)、伊立替康、奥沙利铂、抗血管生成和抗表皮生长因子受体(EGFR)抗体在内的标准抗肿瘤药物治疗后进展的转移性结直肠癌(mCRC)患者的后线或末线治疗,或不适合这些标准治疗的患者。在本报告中,我们描述了一例 KRAS 突变型 mCRC 合并肝、肺转移的 67 岁男性患者,该患者既往接受过含 5-FU 和伊立替康的方案治疗失败,但二线单药替拉鲁肽/曲氟尿苷治疗后疾病控制长达 31 个月。根据我们的经验,对于不适合双药或三药化疗的 mCRC 患者,替拉鲁肽/曲氟尿苷不仅可作为末线治疗方案,也可作为更早线的治疗选择,具有一定的可行性和有效性。除了疗效外,它还具有保持生活质量和可管理的毒性特征。鉴于 mCRC 患者年龄的增加及其对保持独立生活方式的愿望,有必要进一步研究替拉鲁肽/曲氟尿苷在 mCRC 系统治疗更早线的应用。