Sequential Treatment with Regorafenib and Trifluridine/Tipiracil ± Bevacizumab in Refractory Metastatic Colorectal Cancer in Community Clinical Practice in the USA.

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2025-03-13 DOI:10.3390/cancers17060969
Daniel H Ahn, Tanios S Bekaii-Saab, Chengbo Yuan, Milena Kurtinecz, Xiaoyun Pan, Zdravko Vassilev, Federica Pisa, Helene Ostojic
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引用次数: 0

Abstract

Background: Regorafenib (R) and Trifluridine/Tipiracil ± bevacizumab (T) are approved for treating refractory metastatic colorectal cancer (mCRC) but their optimal sequence is unclear. This study describes the characteristics/clinical outcomes of patients with mCRC in U.S. clinical practice treated sequentially with R-T or T-R. Methods: A retrospective cohort study of 818 patients treated with R-T or T-R between January 2015 and November 2022 was conducted using an electronic health record-derived database. The primary objective was to describe the demographic/clinical characteristics and biomarker status of patients treated with R-T or T-R, stratified by treatment line/age. Secondary objectives were to evaluate/estimate the frequency of neutropenia and myelosuppression-related treatments, the number/type of subsequent therapies, time to treatment discontinuation (TTD), and overall survival (OS). Results: Baseline characteristics were similar among patients who received R-T (n = 393) or T-R (n = 425). Lower rates of moderate/severe neutropenia (26%/12% vs. 32%/16%) and granulocyte colony-stimulating factor/erythropoietin use (22% vs. 24%) were observed with R-T versus T-R. The median TTD was 8.7 months and 8.5 months with R-T versus 8.1 months and 7.9 months with T-R as third- and fourth-line treatment, respectively. The median OS was 13.1 months and 11.6 months with R-T versus 11.5 months and 10.3 months with T-R as third- and fourth-line treatment, respectively. Conclusions: This study did not show a statistically significant difference in OS with R-T versus T-R. Although limited by its retrospective nature, the study suggested R-T may be preferable to T-R given the observed reduction in neutropenia/myelosuppression-related treatments.

背景:瑞戈非尼(R)和曲氟啶/替吡拉西+贝伐珠单抗(T)被批准用于治疗难治性转移性结直肠癌(mCRC),但其最佳治疗顺序尚不明确。本研究描述了美国临床实践中使用 R-T 或 T-R 顺序治疗的 mCRC 患者的特征/临床结果。方法:利用电子病历数据库对2015年1月至2022年11月期间接受R-T或T-R治疗的818名患者进行了回顾性队列研究。首要目标是描述接受 R-T 或 T-R 治疗的患者的人口统计学/临床特征和生物标志物状态,并按治疗线/年龄进行分层。次要目标是评估/估计中性粒细胞减少症和骨髓抑制相关治疗的频率、后续治疗的次数/类型、治疗终止时间(TTD)和总生存期(OS)。结果接受R-T(393人)或T-R(425人)治疗的患者基线特征相似。R-T与T-R相比,中度/重度中性粒细胞减少率(26%/12% vs. 32%/16%)和粒细胞集落刺激因子/促红细胞生成素使用率(22% vs. 24%)更低。作为三线和四线治疗,R-T的中位TTD分别为8.7个月和8.5个月,而T-R分别为8.1个月和7.9个月。R-T的中位OS分别为13.1个月和11.6个月,而T-R作为三线和四线治疗的中位OS分别为11.5个月和10.3个月。结论:本研究并未显示 R-T 与 T-R 在治疗后的生存期方面存在统计学意义上的显著差异。尽管该研究具有回顾性,但鉴于观察到的中性粒细胞减少症/骨髓抑制相关治疗的减少,该研究认为R-T可能优于T-R。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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