Case report: Long-term survival in a patient with metastatic colorectal cancer treated with trifluridine/tipiracil in the third-line setting

Abstract

Third-line treatment with trifluridine/tipiracil (FTD/TPI) is recommended for patients with metastatic colorectal cancer (mCRC) or gastric/gastroesophageal cancer (GC) who have progressed beyond first- and second-line therapy. We describe a patient with long-term survival following treatment with FTD/TPI. The patient, a 70-year-old woman diagnosed with right-sided mCRC (T3/N1) with metastases to the aortocaval and precaval lymph nodes, received first-line panitumumab and capecitabine for 6 months, followed by second-line bevacizumab and oxaliplatin. She had disease progression following 9 months of second-line therapy and began third-line treatment with FTD/TPI (50 mg bid). Three months after treatment initiation, lymph node involvement was reduced, and following 12 months of FTD/TPI treatment, her disease had stabilized, and she reported no treatment-related adverse events. She remained on the same dose of FTD/TPI for more than 27 months after initiating treatment, with maintenance of stable disease. This patient with mCRC demonstrated a survival benefit with FTD/TPI beyond those reported in published clinical trial data and real-world studies.

Long-Term Survival in a Patient with Metastatic Colorectal Cancer Treated with Trifluridine/Tipiracil as Late-Line Chemotherapy: A Case Report

“…A previous case report describing long-term disease control with FTD/TPI in a 73-year-old patient with mCRC also reported anti-VEGF and anti-EGFR therapy use prior to treatment with FTD/TPI ( Table 2 ) [ 25 ]. An additional case study described a patient with mCRC who had received bevacizumab in previous lines of therapy who went on to maintain stable disease for more than 27 months with FTD/TPI third-line treatment ( Table 2 ) [ 15 ]. Although the effect of previous treatment with targeted therapies on the long-term survival benefit of FTD/TPI cannot be determined from this report, it poses an interesting avenue for further work.…”

“…In the RECOURSE trial, although the mOS was 7.1 months, the 1-year survival was 27% (compared with 18% with placebo), and therefore, there are some patients who gain much longer survival benefits with FTD/TPI. Published cases have shown long-term survival and maintenance of quality of life (QoL) with FTD/TPI as late-line chemotherapy in other recurrent gastrointestinal cancers [ 13 – 15 ]. Here, we report the details of a patient with mCRC with long-term survival following treatment with FTD/TPI.…”