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dc.contributor.authorKhan, Sam
dc.contributor.authorChauhan, Meera
dc.contributor.authorThomas, Anne
dc.date.accessioned2022-02-01T11:07:16Z
dc.date.available2022-02-01T11:07:16Z
dc.date.issued2021
dc.identifier.citationStavraka, C., Pouptsis, A., Synowiec, A., Angelis, V., Satterthwaite, L., Khan, S., Chauhan, M., Holden, C., Young, S., Karampera, C., Martinou, M., Mills-Baldock, T., Baxter, M., Barry, A., Eccles, B., Iveson, T., Shiu, K. K., Hill, M., Abdel-Raouf, S., Graham, J. S., … Ross, P. J. (2021). Trifluridine/Tipiracil in Metastatic Colorectal Cancer: A UK Multicenter Real-world Analysis on Efficacy, Safety, Predictive and Prognostic Factors. Clinical colorectal cancer, 20(4), 342–349. https://doi.org/10.1016/j.clcc.2021.09.009en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12904/15141
dc.description.abstractBackground: The orally administered combination trifluridine/tipiracil has been approved as third line treatment in mCRC, demonstrating survival benefit and acceptable toxicity profile in the phase III RECOURSE study. Patient and methods: We performed a multicenter retrospective real-world analysis of patients with mCRC receiving trifluridine/tipiracil between 2016 and 2019 in eight cancer centers across the United Kingdom. Results: A total of 236 patients were included with median age of 69 years. All patients had received at least 2 lines of fluoropyrimidine-based chemotherapy doublet with oxaliplatin or irinotecan. About 10% of patients had ECOG ≥ 2. Median duration of trifluridine/tipiracil treatment was 3 months with an ORR of 2.1% and disease control rate of 21.6%. Median OS was 7.6 and median PFS 3.3 months. A dose reduction was required in 27% of patients, while 7.6% discontinued treatment due to toxicity. The most common grade 3 toxicities were neutropenia (34%), fatigue (10%), anemia (9%) and febrile neutropenia (5%). Baseline NLR <5 and CEA <200 had favorable prognostic (HR: 0.52 and 0.39, P≤ .001) and predictive value (OR: 4.1 and 6.7, P< .05). Development of grade 3 neutropenia predicted treatment response (OR: 0.32, P< .001). Following treatment with trifluridine/tipiracil 41% were referred for phase I trial or rechallenged with chemotherapy. Conclusion: Trifluridine/tipiracil is well tolerated in refractory mCRC patients with comparable efficacy and toxicity profile to that of the phase III RECOURSE. Pretreatment NLR and CEA could serve as potential markers for patient selection, while treatment-induced grade 3 neutropenia predicted response. Prospective validation is needed.
dc.description.urihttps://www.clinical-colorectal-cancer.com/article/S1533-0028(21)00095-5/fulltexten_US
dc.language.isoenen_US
dc.subjectLonsurfen_US
dc.subjectneutropeniaen_US
dc.subjectreal-world evidenceen_US
dc.subjectTAS-102en_US
dc.subjecttreatment outcomesen_US
dc.titleTrifluridine/Tipiracil in metastatic colorectal cancer: a UK multicenter real-world analysis on efficacy, safety, predictive and prognostic factorsen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.versionofrecordhttps://doi.org/10.1016/j.clcc.2021.09.009en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2021
html.description.abstractBackground: The orally administered combination trifluridine/tipiracil has been approved as third line treatment in mCRC, demonstrating survival benefit and acceptable toxicity profile in the phase III RECOURSE study. Patient and methods: We performed a multicenter retrospective real-world analysis of patients with mCRC receiving trifluridine/tipiracil between 2016 and 2019 in eight cancer centers across the United Kingdom. Results: A total of 236 patients were included with median age of 69 years. All patients had received at least 2 lines of fluoropyrimidine-based chemotherapy doublet with oxaliplatin or irinotecan. About 10% of patients had ECOG ≥ 2. Median duration of trifluridine/tipiracil treatment was 3 months with an ORR of 2.1% and disease control rate of 21.6%. Median OS was 7.6 and median PFS 3.3 months. A dose reduction was required in 27% of patients, while 7.6% discontinued treatment due to toxicity. The most common grade 3 toxicities were neutropenia (34%), fatigue (10%), anemia (9%) and febrile neutropenia (5%). Baseline NLR <5 and CEA <200 had favorable prognostic (HR: 0.52 and 0.39, P≤ .001) and predictive value (OR: 4.1 and 6.7, P< .05). Development of grade 3 neutropenia predicted treatment response (OR: 0.32, P< .001). Following treatment with trifluridine/tipiracil 41% were referred for phase I trial or rechallenged with chemotherapy. Conclusion: Trifluridine/tipiracil is well tolerated in refractory mCRC patients with comparable efficacy and toxicity profile to that of the phase III RECOURSE. Pretreatment NLR and CEA could serve as potential markers for patient selection, while treatment-induced grade 3 neutropenia predicted response. Prospective validation is needed.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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