Regorafenib-to-trifluridine/tipiracil Versus the Reverse Sequence for Refractory Metastatic Colorectal Cancer Patients: A Multicenter Retrospective Real-life Experience

Anticancer Res. 2021 May;41(5):2553-2561. doi: 10.21873/anticanres.15033.

Abstract

Background/aim: Regorafenib (REG) and trifluridine/tipiracil (FTD/TPI) have have been shown to improve overall survival in patients with refractory metastatic colorectal cancer. The aim of our study was to evaluate the efficacy and safety profiles of these agents administered in sequence in real world practice.

Patients and methods: Clinical data of patients treated beyond the 2°line with REG or FTD/TPI between January 2016 and August 2020, were retrospectively collected from eight institutes in the Lazio Region.

Results: We included 49 patients treated with both drug sequences. A total of 28 G3/G4 toxicity events (53.8%) were recorded in the FTD/TPI-to-REG sequence vs. 24 (46.1%) in the reverse sequence. Median overall survival for the patients included in the FTP/TPI-to-REG group was 20 months (95%CI=16.7-23.3) vs. 27 months in the reverse group (95%CI=17.8-36.2). The disease control rate was 45.0% for patients treated with the REG-to-FTD/TPI sequence vs. 24.1% in those treated with the FTD/TPI-to-REG sequence (p=0.18).

Conclusion: The sequence REG-to-FTD/TPI and vice versa can extend survival, whereas only REG-to-FTD/TPI stabilizes cancer growth.

Keywords: Regorafenib; real-world practice; refractory metastatic colorectal cancer; trifluridine/tipiracil.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology
  • Drug Administration Schedule
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Phenylurea Compounds / administration & dosage*
  • Phenylurea Compounds / adverse effects
  • Progression-Free Survival
  • Pyridines / administration & dosage*
  • Pyridines / adverse effects
  • Pyrrolidines / administration & dosage*
  • Pyrrolidines / adverse effects
  • Thymine / administration & dosage*
  • Thymine / adverse effects
  • Trifluridine / administration & dosage*
  • Trifluridine / adverse effects

Substances

  • Phenylurea Compounds
  • Pyridines
  • Pyrrolidines
  • regorafenib
  • tipiracil
  • Thymine
  • Trifluridine