An Observational Study of Trifluridine/Tipiracil-Containing Regimen Versus Regorafenib-Containing Regimen in Patients With Metastatic Colorectal Cancer

Meng-Che Hsieh; Kun-Ming Rau; Shung-Eing Lin; Kuang-Wen Liu; Chong-Chi Chiu; Chih-I Chen; Ling-Chiao Song; Hsin-Pao Chen

doi:10.3389/fonc.2022.867546

An Observational Study of Trifluridine/Tipiracil-Containing Regimen Versus Regorafenib-Containing Regimen in Patients With Metastatic Colorectal Cancer

Front Oncol. 2022 May 19:12:867546. doi: 10.3389/fonc.2022.867546. eCollection 2022.

Authors

Meng-Che Hsieh^{1

2}, Kun-Ming Rau^{1

2}, Shung-Eing Lin^{2

3}, Kuang-Wen Liu^{2

4}, Chong-Chi Chiu^{2

5}, Chih-I Chen^{2

4}, Ling-Chiao Song^{2

4}, Hsin-Pao Chen^{2

4}

Affiliations

¹ Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan.
² College of Medicine, I-Shou University, Kaohsiung, Taiwan.
³ Division of Colon and Rectum Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.
⁴ Division of Colon and Rectum Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan.
⁵ Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.

Abstract

Background: There are no randomized control trials comparing the efficacy of trifluridine/tipiracil and regorafenib in patients with metastatic colorectal cancer (mCRC). Herein, we conducted an observational study to compare the oncologic outcomes of trifluridine/tipiracil-containing regimen (TAS-102) and regorafenib-containing regimen (REG) in patients with mCRC.

Material and method: Patients who were diagnosed to have mCRC in 2015 to 2021 and treated with TAS-102-containing regimen or REG-containing regimen were recruited. Monotherapy or combination therapy were all allowed in this study. Oncologic outcomes were presented with progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and disease control rate (DCR).

Results: A total of 125 patients were enrolled into our study, accounting for 50 patients with TAS-102 and 75 patients with REG. Of these patients, 64% were treated with TAS-102 or REG monotherapy, while the remaining were treated with TAS-102 combination or REG combination. In general, the median PFS and OS were 3.7 versus 2.0 months (P = 0.006) and 9.2 versus 6.8 months (P = 0.048) in TAS-102 and REG, respectively. The ORR and DCR were 44% versus 20% (P < 0.001) and 72% versus 43% (P < 0.001) in TAS-102 and REG, respectively. As for treatment strategies, the survival were significantly longer in combination than in monotherapy, no matter in TAS-102 or REG group. Multivariate analysis showed TAS-102 and combination therapy were independent predictor associated with better survival.

Conclusions: Our results suggested that TAS-102 had better oncologic outcomes than REG in patients with mCRC, especially in combination. Further prospective trials are warranted to confirm our results.

Keywords: metastatic colorectal carcinoma; oncologic outcome; prognosis; regorafenib; trifluridine/tipiracil.