Three different treatments for metastatic colorectal cancer: a comparison.

This study compared the effectiveness of three different treatments for metastatic (spread to other parts of the body) colorectal cancer (mCRC). Researchers suggested that fruquintinib (Elunate) was associated with the best treatment outcomes.

Colorectal cancer is a common cancer worldwide and 25% of patients present with mCRC at diagnosis. In advanced cases, chemotherapy is only of limited effectiveness. Therefore, combining chemotherapy with other agents such as targeted therapy is frequent. Many patients, who receive these combined first-line therapies, still experience disease progression. However, they still show promising outcomes and can accept a second-line treatment to improve survival.

Regorafenib (Stivarga) is a kinase (protein) inhibitor. This protein is responsible for the growth of cancer cells and regorafenib helps to slow or stop the spread. This therapy has been recommended as a third-line treatment for mCRC.

TAS-102 (Lonsurf) combines trifluridine and tipiracil hydrochloride. These agents stop the tumor cells from growing by damaging their DNA. This drug has been approved in Japan, the USA, and Europe.

Fruquintinib is a VEGFR inhibitor that blocks the tumor from forming new blood vessels and spreading. Prior studies showed the effectiveness of this drug in Chinese patients with mCRC. However, despite showing positive effects, this therapy failed to be approved as standard therapy for mCRC.

The difference in effectiveness and toxicity between regorafenib, TAS-102, and fruquintinib has not been investigated.

This study combined data from 5 clinical trials. It included information about 2586 patients with mCRC. These patients received either treatment with regorafenib, TAS-102, or fruquintinib. Overall survival (OS; time from treatment to death by any cause), progression-free survival (PFS; time from treatment to progression), and toxicity were assessed.

No significant difference in OS was observed between the different therapies. However, fruquintinib had better PFS when compared to TAS-102. Patients who received fruquintinib had a 1.7 times higher chance of a better PFS. PFS was similar between regorafenib and the two other drugs.

All three therapies showed different side effect profiles. However, they were all similar in terms of severity.

This study concluded that fruquintinib had better PFS when compared to TAS-102 and similar PFS compared to regorafenib in the treatment of patients with mCRC. 

This study did not directly compare the three treatments. Further studies are needed for more conclusive evidence.