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Bajpai P, Agarwal S, Afaq F, Al Diffalha S, Chandrashekar DS, Kim HG, Shelton A, Miller CR, Singh SK, Singh R, Varambally S, Nagaraju GP, Manne A, Paluri R, Khushman M, Manne U. Combination of dual JAK/HDAC inhibitor with regorafenib synergistically reduces tumor growth, metastasis, and regorafenib-induced toxicity in colorectal cancer. J Exp Clin Cancer Res 2024; 43:192. [PMID: 38992681 PMCID: PMC11238352 DOI: 10.1186/s13046-024-03106-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/22/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Treatment with regorafenib, a multiple-kinase inhibitor, to manage metastatic colorectal cancers (mCRCs) shows a modest improvement in overall survival but is associated with severe toxicities. Thus, to reduce regorafenib-induced toxicity, we used regorafenib at low concentration along with a dual JAK/HDAC small-molecule inhibitor (JAK/HDACi) to leverage the advantages of both JAK and HDAC inhibition to enhance antitumor activity. The therapeutic efficacy and safety of the combination treatment was evaluated with CRC models. METHODS The cytotoxicity of JAK/HDACi, regorafenib, and their combination were tested with normal colonic and CRC cells exhibiting various genetic backgrounds. Kinomic, ATAC-seq, RNA-seq, cell cycle, and apoptosis analyses were performed to evaluate the cellular functions/molecular alterations affected by the combination. Efficacy of the combination was assessed using patient-derived xenograft (PDX) and experimental metastasis models of CRC. To evaluate the interplay between tumor, its microenvironment, and modulation of immune response, MC38 syngeneic mice were utilized. RESULTS The combination therapy decreased cell viability; phosphorylation of JAKs, STAT3, EGFR, and other key kinases; and inhibited deacetylation of histone H3K9, H4K8, and alpha tubulin proteins. It induced cell cycle arrest at G0-G1 phase and apoptosis of CRC cells. Whole transcriptomic analysis showed that combination treatment modulated molecules involved in apoptosis, extracellular matrix-receptor interaction, and focal adhesion pathways. It synergistically reduces PDX tumor growth and experimental metastasis, and, in a syngeneic mouse model, the treatment enhances the antitumor immune response as evidenced by higher infiltration of CD45 and cytotoxic cells. Pharmacokinetic studies showed that combination increased the bioavailability of regorafenib. CONCLUSIONS The combination treatment was more effective than with regorafenib or JAK/HDACi alone, and had minimal toxicity. A clinical trial to evaluate this combination for treatment of mCRCs is warranted.
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Affiliation(s)
- Prachi Bajpai
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sumit Agarwal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Farrukh Afaq
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sameer Al Diffalha
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Hyung-Gyoon Kim
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Abigail Shelton
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - C Ryan Miller
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Santosh K Singh
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Rajesh Singh
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Sooryanarayana Varambally
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Ashish Manne
- Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Ravi Paluri
- Department of Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Moh'd Khushman
- Department of Medicine, Washington University in St. Louis/Siteman Cancer Center, St. Louis, MO, USA
| | - Upender Manne
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
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Darmadi D, Sungkar T, Pakpahan C, Surja SS. An Efficacy and Safety Comparison of Regorafenib and Nivolumab in Unresectable Hepatocellular Cancer Patients: A Systematic Review. Acta Med Acad 2024; 53:46-58. [PMID: 38984699 PMCID: PMC11237911 DOI: 10.5644/ama2006-124.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 04/29/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE This systematic review aimed to compare the efficacy and safety of regorafenib and nivolumab, two FDA-approved second-line treatments for unresectable Hepatocellular Carcinoma (HCC). METHODS Literature comparing the efficacy and safety of regorafenib and nivolumab in unresectable HCC patients was systematically searched across seven databases, including: PubMed, SCOPUS, Cochrane Database of Systematic Reviews, ScienceDirect, EBSCOhost, EMBASE, and ProQuest, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The search was done on April 2nd, 2023. Study quality and risk of bias were assessed using the Agency for Healthcare Research and Quality (AHRQ) and ROBINS-1 tools. The selected studies were included in the qualitative data synthesis. RESULTS Three trials found that HCC patients taking nivolumab had statistically insignificantly longer OS, TTP, and progression-free survival than those on regorafenib. Nivolumab increased ORR, with largely partial responses, and mixed DCR, with little statistical significance. All three studies showed that nivolumab had fewer side effects and improved tolerance. DISCUSSION Three retrospective cohort studies with a total of 383 regorafenib-receiving cohorts and 230 nivolumab-receiving cohorts were included in the qualitative analysis. Nivolumab was found to be superior in regards of longer overall survival, longer time to progression, higher objective response rate, and lower adverse event occurrence. However, statistical significance was not achieved in most of the parameters. CONCLUSIONS The use of nivolumab is preferable as the second-line systemic therapy for unresectable HCC. More high-quality studies are urgently needed to generate quantitative analysis, and to encourage the formation of guidelines for second-line systemic therapy.
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Affiliation(s)
- Darmadi Darmadi
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. ; https://orcid.org/0000-0001-5281-168X
| | - Taufik Sungkar
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. https://orcid.org/0000-0002-7736-8677
| | - Cennikon Pakpahan
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. https://orcid.org/0000-0003-0157-1131
| | - Sem Samuel Surja
- Department of Parasitology, School of Medicine and Health Sciences, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia. https://orcid.org/0000-0001-5981-0014
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Taşçı EŞ, Oyan B, Sönmez Ö, Mutlu AU, Atcı MM, Sakin A, Öner İ, Çınkır HY, Eryılmaz MK, Çağlayan D, Balçık OY, Paksoy N, Karabulut S, Salim DK, Bilir C, Özen M, Özçelik M, Arıcan A, Akagündüz B, İnal A, Aydın D, Özer L, Gülmez A, Turhal NS, Esen SA, Algın E, Akbaş S, İriağaç Y, Şakalar T, Ünal Ç, Er Ö, Seçmeler Ş, Bozkurt M. Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer. BMC Cancer 2024; 24:16. [PMID: 38166764 PMCID: PMC10763265 DOI: 10.1186/s12885-023-11783-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC. METHODS In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed. RESULTS Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49-14.49) and 8.08 months (95% CI, 6.88-9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment. CONCLUSION Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.
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Affiliation(s)
- Elif Şenocak Taşçı
- Department of Medical Oncology, Saglık Bilimleri University, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey.
| | - Başak Oyan
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Özlem Sönmez
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Arda Ulaş Mutlu
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Muhammed Mustafa Atcı
- Department of Medical Oncology, Haseki Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Medipol Bahçelievler Hospital, Istanbul, Turkey
| | - İrem Öner
- Department of Medical Oncology, Konya City Hospital, Konya, Turkey
| | - Havva Yeşil Çınkır
- Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Melek Karakurt Eryılmaz
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Dilek Çağlayan
- Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | - Onur Yazdan Balçık
- Department of Medical Oncology, Mardin Education and Research Hospital, Mardin, Turkey
| | - Nail Paksoy
- Department of Medical Oncology, Tekirdağ Dr. İsmail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Turkey
| | - Senem Karabulut
- Department of Medical Oncology, Şişli Kolan Hospital, Istanbul, Turkey
| | - Derya Kıvrak Salim
- Department of Medical Oncology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Cemil Bilir
- Department of Medical Oncology, Medical Park Hospital, Istanbul, Turkey
| | - Miraç Özen
- Department of Medical Oncology, Sakarya University Research and Education Hospital, Sakarya, Turkey
| | - Melike Özçelik
- Department of Medical Oncology, University of Health Sciences Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Ali Arıcan
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Baran Akagündüz
- Department of Medical Oncology, Binali Yıldırım University, Erzincan, Turkey
| | - Ali İnal
- Department of Medical Oncology, Mersin City Hospital, Mersin, Turkey
| | - Dinçer Aydın
- Department of Medical Oncology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Leyla Özer
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Ahmet Gülmez
- Department of Medical Oncology, Adana City Hospital, Adana, Turkey
| | | | - Selin Aktürk Esen
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Efnan Algın
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Sinem Akbaş
- Department of Medical Oncology, Koç University Hospital, Istanbul, Turkey
| | - Yakup İriağaç
- Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey
| | - Teoman Şakalar
- Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Çağlar Ünal
- Department of Medical Oncology, Bilim University, Istanbul, Turkey
| | - Özlem Er
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
| | - Şaban Seçmeler
- Department of Medical Oncology, Medical Park Bahçelievler Hospital, Istanbul, Turkey
| | - Mustafa Bozkurt
- Department of Medicine, Acıbadem MAA University, Istanbul, Turkey
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Ozkan M, Oflazoglu U, Yildiz Y, Güc ZG, Salman T, Ünal S, Kücükzeybek Y, Alacacioglu A. Regorafenib therapy as a third-line treatment for metastatic colorectal cancer: A single center long term experience. Medicine (Baltimore) 2023; 102:e36435. [PMID: 38115370 PMCID: PMC10727636 DOI: 10.1097/md.0000000000036435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/01/2023] [Accepted: 11/10/2023] [Indexed: 12/21/2023] Open
Abstract
This study examined the effects of regorafenib (Reg) on progression-free survival (PFS), overall survival (OS), and adverse events (AEs) in metastatic colorectal cancer (mCRC) patients who underwent targeted treatment and chemotherapy. Reg was administered as a third-line treatment to 84 patients who had undergone 2 rounds of chemotherapy and targeted therapy and subsequently experienced progression. Treatment was initiated with a daily dose of 80 or 120 mg, based on the patient's ability to tolerate the medication, which was increased to 160 mg/day. The median PFS with Reg was 4 ± 0.2 months, while the median OS was 9 ± 1.2 months. When compared to patients who started Reg treatment at 80 mg, patients starting at 160 mg had longer median PFS and OS (PFS:6 ± 2.1 months vs 4 ± 0.2 months; P = .05; OS:13 ± 0.7 months vs 6 ± 1.3 months; P = .069). Patients with right-sided colon cancer who received Reg as third-line therapy had a significantly longer mPFS than those with left-sided colon cancer (8 months ± 4 vs 4 months ± 0.3, P = .039). Patients with KRAS mutations had a prolonged mPFS than those with panRAS-wild type (6 ± 1.6 months vs 4 ± 0.3 months, P = .06). The mPFS contribution in the BRAF mutant subgroup with poor prognosis is promising, as it is similar to that of patients without BRAF mutations (4 months ± 0.8 × 4 months ± 0.5, P = .74). The most common AEs reported were elevated liver enzyme levels and dermatological toxicities.
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Affiliation(s)
- Merve Ozkan
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Utku Oflazoglu
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Yaşar Yildiz
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Zeynep G. Güc
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Tarik Salman
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Sinan Ünal
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Yüksel Kücükzeybek
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
| | - Ahmet Alacacioglu
- İzmir Katip Celebi University, Department of Medical Oncology, Izmir, Turkey
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Aydin SG, Kavak EE, Topcu A, Bayramgil A, Akgul F, Kahraman S, Aykan MB, Altıntas YE, Helvaci K, Urun Y, Bilici A, Seker M, Nahit Sendur MA, Olmez OF, Acikgoz O, Cicin I. Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study. BIOMOLECULES & BIOMEDICINE 2023; 23:1089-1095. [PMID: 37289436 PMCID: PMC10655877 DOI: 10.17305/bb.2023.9253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/09/2023]
Abstract
Regorafenib, an oral multikinase inhibitor, has improved survival in metastatic colorectal cancer (mCRC) patients who have progressed on standard therapies. Our study aimed to evaluate prognostic factors influencing regorafenib treatment and assess the optimal dosing regimen in a real-life setting. We retrospectively analysed 263 patients with mCRC from multiple medical oncology clinics in Turkey. Treatment responses and prognostic factors for survival were evaluated using univariate and multivariate analysis. Of the patients, 120 were male, and 143 were female; 28.9% of tumors were located in the rectum. RAS mutations were present in 3.0% of tumors, while BRAF, K-RAS, and N-RAS mutations were found in 3.0%, 29.7%, and 25.9% of tumor tissues, respectively. Dose escalation was preferred in 105 (39.9%) patients. The median treatment duration was 3.0 months, with an objective response rate (ORR) of 4.9%. Grade ≥ 3 treatment-related toxicity occurred in 133 patients, leading to discontinuation, interruption, and modification rates of 50.6%, 43.7%, and 79.0%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.0 and 8.1 months, respectively. RAS/RAF mutation (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1-2.3; P = 0.01), pretreatment carcinoembryonic antigen (CEA) levels (HR 1.6, 95% CI 1.1-2.3; P = 0.008), and toxicity-related treatment interruption or dose adjustment (HR 1.6, 95% CI 1.1-2.4; P = 0.01) were identified as independent prognostic factors for PFS. Dose escalation had no significant effect on PFS but was associated with improved OS (P < 0.001). Independent prognostic factors for OS were the initial TNM stage (HR 1.3, 95% CI 1.0-1.9; P = 0.04) and dose interruption/adjustment (HR 0.4, 95% CI 0.2-0.9; P = 0.03). Our findings demonstrate the efficacy and safety of regorafenib. Treatment line influences the response, with dose escalation being more favorable than adjustment or interruption, thus impacting survival.
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Affiliation(s)
- Sabin Goktas Aydin
- Department of Medical Oncology, Medical Faculty, Medipol University, Istanbul, Turkey
| | - Engin Eren Kavak
- Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey
| | - Atakan Topcu
- Department of Medical Oncology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Ayberk Bayramgil
- Department of Medical Oncology, Medical Faculty, Medipol University, Istanbul, Turkey
| | - Fahri Akgul
- Department of Medical Oncology, Medical Faculty, Trakya University, Edirne, Turkey
| | - Seda Kahraman
- Department of Medical Oncology, Medical Faculty, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Musa Baris Aykan
- Department of Medical Oncology, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Yunus Emre Altıntas
- Department of Medical Oncology, Medical Faculty, Koc University, Istanbul, Turkey
| | - Kaan Helvaci
- Department of Medical Oncology, Memorial Ankara Hospital, Ankara, Turkey
| | - Yuksel Urun
- Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey
| | - Ahmet Bilici
- Department of Medical Oncology, Medical Faculty, Medipol University, Istanbul, Turkey
| | - Mesut Seker
- Department of Medical Oncology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Medical Faculty, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Omer Fatih Olmez
- Department of Medical Oncology, Medical Faculty, Medipol University, Istanbul, Turkey
| | - Ozgur Acikgoz
- Department of Medical Oncology, Medical Faculty, Medipol University, Istanbul, Turkey
| | - Irfan Cicin
- Department of Medical Oncology, Medical Faculty, Trakya University, Edirne, Turkey
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Lee WJA, Chung WP, Shao SC, Lai ECC, Chen YC, Ho CH. Risk of retinal vein occlusion in colorectal cancer patients receiving anti-vascular endothelial growth factors - a population-based cohort study. BMC Cancer 2023; 23:545. [PMID: 37316803 DOI: 10.1186/s12885-023-11037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Anti-vascular endothelial growth factors (VEGFs) treatment has been associated with an increased risk of thromboembolic events. Therefore, the use of anti-VEGFs for patients with colorectal cancers (CRC) has raised concerns about the potential risk of retinal vein occlusion (RVO), an ocular disease caused by embolism or venous stasis. This study aims to evaluate the risk of RVO in patients with CRC treated with anti-VEGFs. METHOD We conducted a retrospective cohort study using the Taiwan Cancer Registry and National Health Insurance Database. The study cohort comprised patients newly diagnosed with CRC between 2011 and 2017, who received anti-VEGF treatment. For each patient in the study cohort, a control group comprising four patients newly diagnosed with CRC, but not receiving anti-VEGF treatment, was randomly selected. A washout period of 12 months was implemented to identify new cases. The index date was defined as the date of the first prescription of anti-VEGF drugs. The study outcome was the incidence of RVO, as identified by ICD-9-CM (362.35 and 362.36) or ICD-10-CM codes (H3481 and H3483). Patients were followed from their index date until the occurrence of RVO, death or the end of the study period. Covariates, including patients' age at index date, sex, calendar year of CRC diagnosis, stage of CRC and comorbidities related to RVO, were included. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HRs) with adjustments for all covariates to compare the risk of RVO between the anti-VEGF and control groups. RESULTS We recruited 6285 patients in the anti-VEGF group and 37,250 patients in the control group, with mean ages of 59.49 ± 12.11 and 63.88 ± 13.17 years, respectively. The incidence rates were 1.06 per 1000 person-years for the anti-VEGF group, and 0.63 per 1000 person-years for the controls. There was no statistically significant difference in RVO risk between the anti-VEGF and control groups (HR: 2.21, 95% CI: 0.87-5.61). CONCLUSION Our results indicated no association between use of anti-VEGF and occurrence of RVO among CRC patients, although the crude incidence rate of RVO was higher in patients receiving anti-VEGF, compared to control patients. Future study with larger sample size is required to confirm our findings.
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Affiliation(s)
- Wan-Ju Annabelle Lee
- Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Wei-Pang Chung
- Department of Oncology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Center of Applied Nanomedicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Chieh Shao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chen Chen
- Department of Medical Research, Chi Mei Medical Center, No 901, Zhonghua Road, Yongkang District, Tainan, 710, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, No 901, Zhonghua Road, Yongkang District, Tainan, 710, Taiwan.
- Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
- Cancer Center, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.
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Özet A, Dane F, Aykan NF, Yalçın Ş, Evrensel T, Özkan M, Karabulut B, Ormeci MN, Atasev O, Vidot L, Çiçin İ. Safety and efficacy of trifluridine/tipiracil in previously treated metastatic colorectal cancer: PRECONNECT Turkey. Future Oncol 2022; 18:3267-3276. [PMID: 36040321 DOI: 10.2217/fon-2022-0455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: The efficacy and safety of trifluridine/tipiracil (FTD/TPI) for third-line treatment of metastatic colorectal cancer have been demonstrated. The authors present the Turkish post hoc analysis of the PRECONNECT study. Methods: An international, multicenter, single-arm, open-label, phase IIIb trial evaluating FTD/TPI in patients with ≥2 previous lines of chemotherapy for metastatic colorectal cancer was conducted. The primary end point was safety. Results: In this Turkish cohort (n = 100; eight centers), the most frequent treatment-emergent adverse event was neutropenia (48%). Median progression-free survival was 3.0 months; disease control rate was 36%; quality of life remained stable. Conclusion: Outcomes with FTD/TPI in Turkey are consistent with previous studies and confirm the efficacy and safety of FTD/TPI treatment in the third-line setting. Clinical Trial Registration: NCT03306394 (ClinicalTrials.gov).
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Affiliation(s)
- Ahmet Özet
- Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, 06560, Turkey
| | - Faysal Dane
- Division of Medical Oncology, Department of Internal Medicine, Marmara University Medical Faculty, Istanbul, 34854, Turkey
| | - Nuri Faruk Aykan
- Department of Medical Oncology, Istinye University Medical Faculty, Istanbul, 34010, Turkey
| | - Şuayib Yalçın
- Hacettepe University Institute of Cancer, Department of Medical Oncology, Ankara, 06230, Turkey
| | - Türkkan Evrensel
- Department of Medical Oncology, Uludağ University Medical Faculty, Bursa, 16059, Turkey
| | - Metin Özkan
- Department of Medical Oncology, Erciyes University Medical Faculty, Kayseri, 38280, Turkey
| | - Bülent Karabulut
- Department of Medical Oncology, Özel İzmir Kent Hospital, İzmir, 35620, Turkey
| | | | - Ozan Atasev
- Servier Pharmaceuticals, Istanbul, 34398, Turkey
| | - Loïck Vidot
- Servier Pharmaceuticals, Suresnes, 92150, France
| | - İrfan Çiçin
- Department of Medical Oncology, Trakya University, Edirne, 22030, Turkey
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Baz HAH, Halawani SH, Abdulaziz I, Ali M, Baz NA, Jafal M, Saleh K. Regorafenib Adverse Drug Reactions among Patients in King Abdullah Medical City; A Chart Review Study. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2022. [DOI: 10.51847/iexpv4xrns] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chen Y, Zheng X, Wu C. The Role of the Tumor Microenvironment and Treatment Strategies in Colorectal Cancer. Front Immunol 2021; 12:792691. [PMID: 34925375 PMCID: PMC8674693 DOI: 10.3389/fimmu.2021.792691] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022] Open
Abstract
Colorectal cancer (CRC) has the second highest mortality rate among all cancers worldwide. Surgery, chemotherapy, radiotherapy, molecular targeting and other treatment methods have significantly prolonged the survival of patients with CRC. Recently, the emergence of tumor immunotherapy represented by immune checkpoint inhibitors (ICIs) has brought new immunotherapy options for the treatment of advanced CRC. As the efficacy of ICIs is closely related to the tumor immune microenvironment (TME), it is necessary to clarify the relationship between the immune microenvironment of CRC and the efficacy of immunotherapy to ensure that the appropriate drugs are selected. We herein review the latest research progress in the immune microenvironment and strategies related to immunotherapy for CRC. We hope that this review helps in the selection of appropriate treatment strategies for CRC patients.
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Affiliation(s)
- Yaping Chen
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao Zheng
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Changping Wu
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
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