Neutropenia is an indicator of outcomes in metastatic colorectal cancer patients treated with FTD/TPI plus bevacizumab: a retrospective study.

Abstract

PURPOSE:

Trifluridine/tipiracil (FTD/TPI) improves the overall survival (OS) of metastatic colorectal cancer (mCRC) patients. Additionally, FTD/TPI plus bevacizumab (BEV) has demonstrated promising efficacy for mCRC patients who are refractory to standard chemotherapy. Chemotherapy-induced neutropenia (CIN) has been reported to be an indicator of efficacy for FTD/TPI. This study investigated whether CIN was an indicator of efficacy for FTD/TPI plus BEV.

METHODS:

We reviewed chemo-refractory mCRC patients who were treated with FTD/TPI alone (monotherapy) or FTD/TPI plus BEV (combination) at our institution and compared the safety and efficacy of the two. Progression-free survival (PFS) and OS were analyzed using Kaplan-Meier curves. We also investigated correlations between CIN and outcomes.

RESULTS:

In total, 56 patients received FTD/TPI, among whom 24 and 32 were treated with monotherapy and combination therapy, respectively. The median PFS was 1.8 and 4.7 months for the monotherapy and combination arms, respectively (hazard ratio [HR]: 0.28; 95% confidence interval [CI]: 0.15-0.51; P < 0.001). The median OS was 6.3 and 11.7 months for the monotherapy and combination arms, respectively (HR 0.25; 95% CI 0.13-0.48; P < 0.001). CIN (Grade 3 or worse) developed in five (20.8%) and 17 (53.1%) patients from the monotherapy and combination arms, respectively (P = 0.030). Patients with CIN in the combination arm had improved PFS and OS compared with non-CIN patients (P = 0.033 and P = 0.045, respectively).

CONCLUSIONS:

FTD/TPI plus BEV prolonged PFS and OS and had tolerable toxicity compared with FTD/TPI alone. CIN is an indicator of patients who will benefit from FTD/TPI plus BEV.

• Authors: Yohei Nose, Yoshinori Kagawa, Taishi Hata, Ryota Mori, Kenji Kawai, Atsushi Naito, Takuya Sakamoto, Kohei Murakami, Yoshiteru Katsura, Yoshiaki Ohmura, Toru Masuzawa, Atsushi Takeno, Yutaka Takeda, Takeshi Kato, Kohei Murata
• Journal: Cancer chemotherapy and pharmacology (Cancer Chemother Pharmacol) Vol. 86 Issue 3 Pg. 427-433 (09 2020) ISSN: 1432-0843 [Electronic] Germany
• PMID: 32816155 (Publication Type: Journal Article)

Chemical References

• Drug Combinations
• Pyrrolidines
• trifluridine tipiracil drug combination
• Bevacizumab
• Thymine
• Trifluridine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Bevacizumab (administration & dosage)
• Colorectal Neoplasms (drug therapy, mortality, pathology)
• Drug Combinations
• Drug Resistance, Neoplasm (drug effects)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy, mortality, pathology)
• Neutropenia (chemically induced, diagnosis)
• Prognosis
• Pyrrolidines (administration & dosage)
• Retrospective Studies
• Survival Rate
• Thymine (administration & dosage)
• Trifluridine (administration & dosage)