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Posted by on Feb 21, 2020 in Colorectal cancer | 0 comments

In a nutshell

This study investigated the safety and effectiveness of TAS-102 (trifluridine-tipiracil) with and without bevacizumab (Avastin) therapy in metastatic colorectal cancer (mCRC). Researchers suggested that this combined therapy might be a good treatment option for patients with advanced CRC.

Some background

Colorectal cancer is the third most common cancer worldwide. A significant number of patients present mCRC (spread to other parts of the body) at diagnosis. The standard treatment for these patients is chemotherapy combined with targeted therapy. Around 50% of mCRC patients respond well to first-line treatments. These numbers decrease to 10 to 20% for second-line treatment and for third-line treatments there is almost no response. Therefore, there is an unmet medical need for new treatment drugs. 

TAS-102 consists of a combination of 2 drugs that have an anti-tumor growth effect. It has been proven to be a safe drug that prolongs survival in patients with mCRC. However, the survival increase is limited and there is a need for improvement. Combining this drug with targeted therapy, such as bevacizumab, might increase effectiveness. Bevacizumab also improves progression and survival by blocking tumor growth. Even though prior studies showed the effectiveness of this combined therapy in mCRC patients, more studies are needed.

Methods & findings

This study included information about 93 patients with mCRC. These patients were assigned to receive TAS-102 alone (47) and with bevacizumab (46). The average follow-up period was 10 months. Progression-free survival (PFS; from treatment to progression) and safety were assessed.

The average PFS in the TAS-102 alone group was 2.6 months, while in the combined therapy group was 4.6. Patients receiving the combined therapy had a 55% improvement in the odds of a better PFS.

The most frequent moderate side effect was neutropenia (low levels of white blood cells). It was present in 38% of patients in the TAS-102 alone group and 67% in the combined therapy group.

Severe side effects were seen in 45% of the TAS-102 alone group and 41% in the combination group. No treatment-related deaths were observed.

The bottom line

This study concluded that combining TAS-102 and bevacizumab improves the PFS of mCRC patients with manageable side effects.

The fine print

This study included a limited number of participants and a short follow-up period. Further long-term studies, with bigger populations, are needed.

Published By :

The Lancet. Oncology

Date :

Jan 27, 2020

Original Title :

TAS-102 with or without bevacizumab in patients with chemorefractory metastatic colorectal cancer: an investigator-initiated, open-label, randomised, phase 2 trial.

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