A systematic review of salvage therapies in refractory metastatic colorectal cancer

Petrelli, Fausto; Perego, Gianluca; Ghidini, Antonio; Ghidini, Michele; Borgonovo, Karen; Scolari, C; Nozza, Renata; Rampulla, Valentina; Costanzo, Antonio; Varricchio, Antonio; Rausa, Emanuele; Pietrantonio, Filippo; Zaniboni, Alberto

doi:10.1007/s00384-020-03571-5

Cited by 8 publications

(3 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In third-line setting, an anti-EGFR agent alone or in combination with an irinotecan-based chemotherapy may be appropriate in treatment-naive patients with RAS wild-type tumors [5]. Alternatively, chemotherapeutic agents or treatment combinations used in earlier therapy lines may be reintroduced, as long as there is no clear prior resistance to these agents, but there is limited evidence to support this approach [7]. Other agents for refractory mCRC have limited usefulness because they are approved only in certain territories, or only for specific tumor types.…”

mentioning

confidence: 99%

Trifluridine/Tipiracil Plus Bevacizumab for Third-Line Management of Metastatic Colorectal Cancer: SUNLIGHT Study Design

Tabernero¹,

Taı̈eb

Prager

et al. 2021

Future Oncol.

View full text Add to dashboard Cite

Trifluridine/tipiracil (FTD/TPI) is an orally active formulation of trifluridine, a thymidine-based nucleoside analog, and tipiracil hydrochloride, a thymidine phosphorylase inhibitor that increases the bioavailability of trifluridine. Preliminary studies of FTD/TPI plus bevacizumab have produced encouraging results in the treatment of refractory metastatic colorectal cancer. Here, we describe the design of the multinational Phase III SUNLIGHT, an open-label study of FTD/TPI plus bevacizumab as third-line treatment for patients with unresectable metastatic colorectal cancer. A total of 490 patients will be randomized 1:1 to receive either FTD/TPI plus bevacizumab, or FTD/TPI monotherapy. The primary objective is to significantly improve overall survival with FTD/TPI plus bevacizumab compared with FTD/TPI monotherapy. The first patient was enrolled in November 2020.

show abstract

mentioning

confidence: 99%

Trifluridine/Tipiracil Plus Bevacizumab for Third-Line Management of Metastatic Colorectal Cancer: SUNLIGHT Study Design

Tabernero¹,

Taı̈eb

Prager

et al. 2021

Future Oncol.

View full text Add to dashboard Cite

show abstract

“…Efficacy findings of our metaanalysis were consistent with those of a recent meta-analysis with mCRC (pooled across 25 studies) in which median PFS was 4.35 and 2.53 months with FTD/TPI + BEV and FTD/TPI monotherapy, respectively, and median OS was 10.41 and 6.95 months, respectively. 51 Furthermore, efficacy results with FTD/ TPI + BEV in our meta-analysis appeared to be superior to those with any later-line regimen reported in a systematic literature review of phase II and phase III trials (67 studies; 7556 patients) in refractory mCRC (median PFS, 3.2 months; median OS, 8.8 months), 52 although it is difficult to make comparisons between different analyses. FTD/TPI + BEV and FTD/TPI monotherapy were shown to be safe and well tolerated in this meta-analysis.…”

Section: Ae Monitoring Schedule and G-csf Usementioning

confidence: 68%

Trifluridine/tipiracil with or without bevacizumab in metastatic colorectal cancer: results of a systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

Background: Trifluridine/tipiracil plus bevacizumab (FTD/TPI + BEV) has shown efficacy and tolerability in refractory metastatic colorectal cancer (mCRC). Because randomized controlled trial (RCT) data comparing FTD/TPI + BEV with FTD/TPI are lacking, this meta-analysis evaluated outcomes with both regimens. Data Sources and Methods: Electronic databases, congress proceedings (past 3 years), trial registries, systematic review bibliographies, gray literature, and guidelines through June 2021 were searched for RCTs, non-RCTs, and prospective observational studies involving >20 previously treated patients with mCRC receiving FTD/TPI + BEV or FTD/TPI. Absolute and relative disease control rate (DCR), progression-free survival (PFS), overall survival (OS), adverse event (AE) rates, and discontinuation rates due to AEs were evaluated using fixed-effects and random-effects models. Study quality, heterogeneity, and publication bias were assessed. Results: In all, 29 of 875 screened publications were selected (26 studies: 5 RCTs, 11 non-RCTs, and 10 prospective observational studies). One RCT compared FTD/TPI + BEV with FTD/TPI. FTD/TPI + BEV versus FTD/TPI had a higher absolute DCR [64% (6 studies; n = 289) versus 43% (10 studies; n = 2809)], median PFS [4.2 (5 studies; n = 244) versus 2.6 (6 studies; n = 1781) months], 12-month PFS [9% (5 studies; n = 244) versus 3% (6 studies; n = 1781)], median OS [9.8 (5 studies; n = 244) versus 8.1 (6 studies; n = 1814) months], and 12-month OS [38% (5 studies; n = 244) versus 32% (6 studies; n = 1814)]. Grade ⩾3 febrile neutropenia, asthenia/fatigue, diarrhea, nausea, and vomiting rates were similar (1%–7%). Grade ⩾3 neutropenia rate was higher with FTD/TPI + BEV than with FTD/TPI [43% (6 studies; n = 294) versus 29% (12 studies; n = 7139)]. Discontinuation rates due to AEs were similar [8% (5 studies; n = 244) and 7% (10 studies; n = 3724)]. Low study quality, heterogeneity, and/or publication bias were detected in certain instances. Conclusion: Despite fewer patients treated with the combination, this meta-analysis consistently suggested that FTD/TPI + BEV provides benefits over FTD/TPI in refractory mCRC and has similar safety, except for more frequent grade ⩾3 neutropenia.

show abstract

“…Trifluoridine is a thymidine-related nucleoid analog and replaces thymidine in DNA ( 87 ). This is while tipiracil strengthens the function of trifluridine by inhibiting the thymidine phosphorylase enzyme ( 88 ). Tipiracil leads to trifluridine replacement in DNA by preventing thymidine bases and ultimately prevents cell proliferation ( 87 ).…”

Section: Colorectal Cancer Chemotherapymentioning

confidence: 99%

Can immunotherapy reinforce chemotherapy efficacy? a new perspective on colorectal cancer treatment

He,

Lan,

Jin

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

As one of the main threats to human life (the fourth most dangerous and prevalent cancer), colorectal cancer affects many people yearly, decreases patients’ quality of life, and causes irreparable financial and social damages. In addition, this type of cancer can metastasize and involve the liver in advanced stages. However, current treatments can’t completely eradicate this disease. Chemotherapy and subsequent surgery can be mentioned among the current main treatments for this disease. Chemotherapy has many side effects, and regarding the treatment of this type of tumor, chemotherapy can lead to liver damage, such as steatohepatitis, steatosis, and sinus damage. These damages can eventually lead to liver failure and loss of its functions. Therefore, it seems that other treatments can be used in addition to chemotherapy to increase its efficiency and reduce its side effects. Biological therapies and immunotherapy are one of the leading suggestions for combined treatment. Antibodies (immune checkpoint blockers) and cell therapy (DC and CAR-T cells) are among the immune system-based treatments used to treat tumors. Immunotherapy targets various aspects of the tumor that may lead to 1) the recruitment of immune cells, 2) increasing the immunogenicity of tumor cells, and 3) leading to the elimination of inhibitory mechanisms established by the tumor. Therefore, immunotherapy can be used as a complementary treatment along with chemotherapy. This review will discuss different chemotherapy and immunotherapy methods for colorectal cancer. Then we will talk about the studies that have dealt with combined treatment.

show abstract

A systematic review of salvage therapies in refractory metastatic colorectal cancer

Cited by 8 publications

References 81 publications

Trifluridine/Tipiracil Plus Bevacizumab for Third-Line Management of Metastatic Colorectal Cancer: SUNLIGHT Study Design

Trifluridine/Tipiracil Plus Bevacizumab for Third-Line Management of Metastatic Colorectal Cancer: SUNLIGHT Study Design

Trifluridine/tipiracil with or without bevacizumab in metastatic colorectal cancer: results of a systematic review and meta-analysis

Can immunotherapy reinforce chemotherapy efficacy? a new perspective on colorectal cancer treatment

Contact Info

Product

Resources

About