Comparing the effectiveness and safety of TAS-102 with or without bevacizumab in patients with metastatic colorectal cancer.

This study evaluated the effectiveness and safety of bevacizumab (Avastin) plus TAS-102 (Lonsurf; trifluridine-tipiracil) versus TAS-102 alone for the treatment of patients with metastatic colorectal cancer (mCRC). The data showed that bevacizumab combined with TAS-102 was effective with manageable side effects in improving the outcomes of these patients.

Colorectal cancer (CRC) is one of the most common types of cancer worldwide. Some patients do not report symptoms with the initial tumor. These patients are often only diagnosed when the cancer has spread to other areas (metastatic CRC). The standard treatment for these patients is chemotherapy combined with targeted therapy.

Bevacizumab is a type of targeted therapy. It works by stopping tumors from forming new blood vessels and spreading. Studies have shown that bevacizumab improves the outcomes of patients with mCRC when added to chemotherapy. TAS-102 is a combination of 2 chemotherapy drugs that stop cancer cells from dividing. This stops tumor growth and spread. Previous studies showed that TAS-102 was safe and improved survival in patients with mCRC. However, whether TAS-102 alone or combined with bevacizumab improves the outcomes of patients with mCRC is still under investigation.

This study analyzed 3 other studies that involved 344 patients with mCRC. Patients were divided into 2 groups. Group 1 included 177 patients who received bevacizumab plus TAS-102. Group 2 included 167 patients who received TAS-102 alone. 

Patients in group 1 were 2.93 times more likely to have better overall survival after 6 months, 2.18 times more likely to have better overall survival after 12 months, and 3.08 times more likely to have better overall survival after 18 months compared to patients in group 2.  

Patients in group 1 were 2.50 times more likely to have a better survival without cancer worsening after 6 months compared to patients in group 2.  

Patients in group 1 were 1.96 times more likely to experience low platelet (blood cells involved in clotting) counts compared to patients in group 2.  Serious side effects were similar between the 2 groups.

This study concluded that bevacizumab combined with TAS-102 improved the outcomes of patients with mCRC.

This study looked back in time at medical records. The sample size was small and only analyzed patients from 3 studies. The selection of patients was biased. Larger unbiased studies are needed to validate the conclusions.