Early Clinical Experience with Trifluridine/Tipiracil for Refractory Metastatic Colorectal Cancer: The ROS Study

Trifluridine/tipiracil is currently approved for metastatic colorectal cancer (mCRC) refractory to available therapies. However, there is no consensus on factors that predict treatment outcomes in daily practice. We assessed the early clinical experience with trifluridine/tipiracil in Spain and pote...

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Published in:Cancers 2021-09, Vol.13 (18), p.4514
Main Authors: García-Alfonso, Pilar, Muñoz, Andrés, Jiménez-Castro, Jerónimo, Jiménez-Fonseca, Paula, Pericay, Carles, Longo-Muñoz, Federico, Reyna-Fortes, Carmen, Argilés-Martínez, Guillem, González-Astorga, Beatriz, Gómez-Reina, María José, Ruiz-Casado, Ana, Rodríguez-Salas, Nuria, López-López, Rafael, Carmona-Bayonas, Alberto, Conde-Herrero, Verónica, Aranda, Enrique
Format: Article
Language:English
Subjects:
Alkaline phosphatase
Cancer
Cancer therapies
Chemotherapy
Colorectal cancer
Colorectal carcinoma
Cytotoxicity
Disease control
Drug dosages
Early experience
Leukocytes (neutrophilic)
Liver
Lymphocytes
Medical prognosis
Metastases
Metastasis
Neutrophils
Patients
Phosphatase
Response rates
Thrombocytopenia
Tumors
Vascular endothelial growth factor
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Summary:Trifluridine/tipiracil is currently approved for metastatic colorectal cancer (mCRC) refractory to available therapies. However, there is no consensus on factors that predict treatment outcomes in daily practice. We assessed the early clinical experience with trifluridine/tipiracil in Spain and potential survival markers. This was a retrospective cohort study of mCRC patients who participated in the trifluridine/tipiracil early clinical experience programme in Spain. The primary outcome was overall survival (OS). Associations between OS and patient characteristics were assessed using multivariate Cox regression analyses. A total of 379 patients were included in the study. Trifluridine/tipiracil was administered for a median of 3.0 cycles and discontinued mainly due to disease progression (79.2%). The median OS was 7.9 months, with a 12-month OS rate of 30.5%. Cox analyses revealed that the following variables independently enhanced OS: ≤2 metastatic sites, no liver metastasis, alkaline phosphatase < 300 IU, trifluridine/tipiracil dose reductions, and neutrophil/lymphocyte ratio < 5. Grade ≥ 3 toxicities were reported in 141 (37.2%) patients, including mainly afebrile neutropaenia (23.2%), anaemia (12.1%), and thrombocytopaenia (5.3%). This study supports the real-life efficacy and safety of trifluridine/tipiracil for refractory mCRC and identifies tumour burden, liver metastasis, alkaline phosphatase, dose reductions, and neutrophil/lymphocyte ratio as survival markers.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13184514