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转移性结直肠癌预处理患者接受替氟尿苷/替匹嘧啶治疗的长期无进展生存。

Long-Term Progression-Free Survival of a Pre-Treated Patient with Metastatic Colorectal Cancer Receiving Trifluridine/Tipiracil.

机构信息

Praxis Dr. Michl, Specialists for Hematology and Oncology, Munich, Germany.

RADIOLOGIE München, Specialists for Radiology, Munich, Germany.

出版信息

Chemotherapy. 2024;69(1):27-34. doi: 10.1159/000531525. Epub 2023 Jun 19.

DOI:10.1159/000531525
PMID:37336201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10898807/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/862f/10898807/04fc0c41ff87/che-2024-0069-0001-531525_F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/862f/10898807/a28d3659e92c/che-2024-0069-0001-531525_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/862f/10898807/04fc0c41ff87/che-2024-0069-0001-531525_F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/862f/10898807/a28d3659e92c/che-2024-0069-0001-531525_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/862f/10898807/04fc0c41ff87/che-2024-0069-0001-531525_F02.jpg

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本文引用的文献

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Trifluridine-Tipiracil and Bevacizumab in Refractory Metastatic Colorectal Cancer.替氟尿苷替匹嘧啶与贝伐珠单抗治疗难治性转移性结直肠癌
N Engl J Med. 2023 May 4;388(18):1657-1667. doi: 10.1056/NEJMoa2214963.
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Trifluridine/tipiracil+bevacizumab (BEV) vs. fluoropyrimidine-irinotecan+BEV as second-line therapy for metastatic colorectal cancer: a randomised noninferiority trial.替氟尿苷/替匹嘧啶+贝伐珠单抗(BEV)对比氟嘧啶-伊立替康+BEV 作为转移性结直肠癌二线治疗:一项随机非劣效性试验。
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Safety and efficacy of trifluridine/tipiracil in previously treated metastatic colorectal cancer: final results from the phase IIIb single-arm PRECONNECT study by duration of therapy.
三氟尿苷/替匹嘧啶在既往治疗转移性结直肠癌中的安全性和有效性:基于治疗持续时间的 IIIb 期单臂 PRECONNECT 研究的最终结果。
BMC Cancer. 2023 Jan 27;23(1):94. doi: 10.1186/s12885-022-10489-4.
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Trifluridine-tipiracil plus bevacizumab versus capecitabine plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer ineligible for intensive therapy (SOLSTICE): a randomised, open-label phase 3 study.替氟嘧啶-替匹嘧啶联合贝伐珠单抗对比卡培他滨联合贝伐珠单抗作为无法接受强化治疗的转移性结直肠癌患者一线治疗方案(SOLSTICE):一项随机、开放标签的3期研究
Lancet Gastroenterol Hepatol. 2023 Feb;8(2):133-144. doi: 10.1016/S2468-1253(22)00334-X. Epub 2022 Dec 2.
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Study protocol of the FIRE-8 (AIO-KRK/YMO-0519) trial: a prospective, randomized, open-label, multicenter phase II trial investigating the efficacy of trifluridine/tipiracil plus panitumumab versus trifluridine/tipiracil plus bevacizumab as first-line treatment in patients with metastatic colorectal cancer.FIRE-8(AIO-KRK/YMO-0519)试验方案:一项前瞻性、随机、开放标签、多中心 II 期试验,旨在研究替氟尿苷/替匹嘧啶联合帕尼单抗与替氟尿苷/替匹嘧啶联合贝伐珠单抗作为转移性结直肠癌一线治疗的疗效。
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Curr Oncol. 2020 Oct;27(5):e451-e458. doi: 10.3747/co.27.6533. Epub 2020 Oct 1.