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Longo-Muñoz F, Castellano D, Alexandre J, Chawla SP, Fernández C, Kahatt C, Alfaro V, Siguero M, Zeaiter A, Moreno V, Sanz-García E, Awada A, Santaballa A, Subbiah V. Lurbinectedin in patients with pretreated neuroendocrine tumours: Results from a phase II basket study. Eur J Cancer 2022; 172:340-348. [PMID: 35830841 DOI: 10.1016/j.ejca.2022.06.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with neuroendocrine tumours (NETs) need alternative therapies after failure of first-line therapy. PATIENTS AND METHODS This phase II trial evaluated lurbinectedin, a selective inhibitor of oncogenic transcription, at 3.2 mg/m2 as a 1-h intravenous infusion every 3 weeks in 32 NETs patients treated in the second- or third-line setting. The primary efficacy endpoint was overall response rate (ORR) according to RECIST v1.1 assessed by the investigators. Secondary endpoints included duration of response (DoR), progression-free survival (PFS), overall survival (OS) and safety. RESULTS Two of 31 evaluable patients had confirmed partial responses (ORR = 6.5%; 95%CI, 0.8-21.4%). Median DoR was 4.7 months (95% CI, 4.0-5.4 months), median PFS was 1.4 months (95% CI, 1.2-3.0 months) and median OS was 7.4 months (95% CI, 3.4-16.2 months). Lurbinectedin showed an acceptable, predictable and manageable safety profile. The most common grade 3/4 toxicity was neutropenia (40.6%; grade 4, 12.4%; febrile neutropenia, 3.1%). CONCLUSIONS Considering the exploratory aim of this trial that evaluated a heterogeneous population of NETs patients, and the signs of antitumour activity observed (two confirmed partial responses and seven long disease stabilisations), further development of lurbinectedin is warranted in a more selected NETs population. TRIAL REGISTRATION NUMBER Sponsor Study Code: PM1183-B-005-14. EudraCT number: 2014-003773-42. CLINICALTRIALS gov reference: NCT02454972.
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Affiliation(s)
| | - Daniel Castellano
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Sant P Chawla
- Medical Oncology, Sarcoma Oncology Center, Santa Monica CA 90403, USA
| | | | | | | | | | - Ali Zeaiter
- Clinical R&D, PharmaMar, Colmenar Viejo, Spain
| | - Victor Moreno
- Medical Oncology, START Madrid-FJD, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Enrique Sanz-García
- Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - Ahmad Awada
- Medical Oncology, Institut Jules Bordet, Université Libre De Bruxelles, Brussels, Belgium
| | | | - Vivek Subbiah
- Medical Oncology, UT MD Anderson Cancer Center, Houston, USA.
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García-Alfonso P, Muñoz A, Jiménez-Castro J, Jiménez-Fonseca P, Pericay C, Longo-Muñoz F, Reyna-Fortes C, Argilés-Martínez G, González-Astorga B, Gómez-Reina MJ, Ruiz-Casado A, Rodríguez-Salas N, López-López R, Carmona-Bayonas A, Conde-Herrero V, Aranda E. Early Clinical Experience with Trifluridine/Tipiracil for Refractory Metastatic Colorectal Cancer: The ROS Study. Cancers (Basel) 2021; 13:cancers13184514. [PMID: 34572740 PMCID: PMC8468101 DOI: 10.3390/cancers13184514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Trifluridine/tipiracil is an oral combination therapy currently approved as a salvage-line treatment in patients with metastatic colorectal cancer refractory to, or not, candidates for available therapies. However, there is no consensus on the specific factors that should be considered to select patients who benefit the most from trifluridine/tipiracil in clinical practice. The aim of our retrospective cohort study was to assess the early clinical experience with trifluridine/tipiracil in Spain and identify potential survival markers. Our findings endorse the real-life efficacy and safety of trifluridine/tipiracil for refractory metastatic colorectal cancer, as well as revealing the presence of ≤2 metastatic sites, absence of liver metastasis, alkaline phosphatase levels < 300 IU, trifluridine/tipiracil dose reductions, and neutrophil/lymphocyte ratio < 5 as survival markers. Combinations of these markers may help physicians to identify subsets of patients with refractory metastatic colorectal cancer that may benefit the most from trifluridine/tipiracil in their daily practice. Abstract Trifluridine/tipiracil is currently approved for metastatic colorectal cancer (mCRC) refractory to available therapies. However, there is no consensus on factors that predict treatment outcomes in daily practice. We assessed the early clinical experience with trifluridine/tipiracil in Spain and potential survival markers. This was a retrospective cohort study of mCRC patients who participated in the trifluridine/tipiracil early clinical experience programme in Spain. The primary outcome was overall survival (OS). Associations between OS and patient characteristics were assessed using multivariate Cox regression analyses. A total of 379 patients were included in the study. Trifluridine/tipiracil was administered for a median of 3.0 cycles and discontinued mainly due to disease progression (79.2%). The median OS was 7.9 months, with a 12-month OS rate of 30.5%. Cox analyses revealed that the following variables independently enhanced OS: ≤2 metastatic sites, no liver metastasis, alkaline phosphatase < 300 IU, trifluridine/tipiracil dose reductions, and neutrophil/lymphocyte ratio < 5. Grade ≥ 3 toxicities were reported in 141 (37.2%) patients, including mainly afebrile neutropaenia (23.2%), anaemia (12.1%), and thrombocytopaenia (5.3%). This study supports the real-life efficacy and safety of trifluridine/tipiracil for refractory mCRC and identifies tumour burden, liver metastasis, alkaline phosphatase, dose reductions, and neutrophil/lymphocyte ratio as survival markers.
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Affiliation(s)
- Pilar García-Alfonso
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
- Correspondence: ; Tel.: +34-915868000
| | - Andrés Muñoz
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
| | - Jerónimo Jiménez-Castro
- Department of Medical Oncology, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain;
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, 33011 Oviedo, Spain;
| | - Carles Pericay
- Department of Medical Oncology, Hospital Universitari Parc Taulí, 08208 Sabadell, Spain;
| | - Federico Longo-Muñoz
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Carmen Reyna-Fortes
- Department of Medical Oncology, UGC Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, 29010 Málaga, Spain;
| | | | - Beatriz González-Astorga
- Department of Medical Oncology, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain;
| | - María José Gómez-Reina
- Department of Medical Oncology, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain;
| | - Ana Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Majadahonda, Spain;
| | - Nuria Rodríguez-Salas
- Department of Medical Oncology, Hospital Universitario La Paz, CIBERONC, 28046 Madrid, Spain;
| | - Rafael López-López
- Translational Medical Oncology Group, Department of Medical Oncology, Hospital Clínico Universitario e Instituto de Investigación Sanitaria (IDIS), CIBERONC, Facultad de Medicina de la Universidad de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Alberto Carmona-Bayonas
- Department of Medical Oncology, Hospital General Universitario Morales Meseguer, 30008 Murcia, Spain;
| | - Verónica Conde-Herrero
- Department of Medical Oncology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | - Enrique Aranda
- Department of Medical Oncology, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBERONC, Instituto de Salud Carlos III, 14004 Córdoba, Spain;
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Auclin E, Vuagnat P, Smolenschi C, Taieb J, Adeva J, Nebot-Bral L, Garcia de Herreros M, Vidal Tocino R, Longo-Muñoz F, El Dakdouki Y, Martín-Romano P, Gaba L, Saurí T, Oliveres H, Castañón E, Garcia-Carbonero R, Besse B, Massard C, Mezquita L, Hollebecque A. Association of the Lung Immune Prognostic Index with Immunotherapy Outcomes in Mismatch Repair Deficient Tumors. Cancers (Basel) 2021; 13:3776. [PMID: 34359675 PMCID: PMC8345164 DOI: 10.3390/cancers13153776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background: MSI-H/dMMR is considered the first predictive marker of efficacy for immune checkpoint inhibitors (ICIs). However, around 39% of cases are refractory and additional biomarkers are needed. We explored the prognostic value of pretreatment LIPI in MSI-H/dMMR patients treated with ICIs, including identification of fast-progressors. Methods: A multicenter retrospective study of patients with metastatic MSI-H/dMMR tumors treated with ICIs between April 2014 and May 2019 was performed. LIPI was calculated based on dNLR > 3 and LDH > upper limit of normal. LIPI groups were good (zero factors), intermediate (one factor) and poor (two factors). The primary endpoint was overall survival (OS), including the fast-progressor rate (OS < 3 months). Results: A total of 151 patients were analyzed, mainly female (59%), with median age 64 years, performance status (PS) 0 (42%), and sporadic dMMR status (68%). ICIs were administered as first or second-line for 59%. The most frequent tumor types were gastrointestinal (66%) and gynecologic (22%). LIPI groups were good (47%), intermediate (43%), and poor (10%). The median follow-up was 32 months. One-year OS rates were 81.0%, 67.1%, and 21.4% for good, intermediate, and poor-risk groups (p < 0.0001). After adjustment for tumor site, metastatic sites and PS, LIPI remained independently associated with OS (HR, poor-LIPI: 3.50, 95%CI: 1.46-8.40, p = 0.02. Overall, the fast-progressor rate was 16.0%, and 35.7% with poor-LIPI vs. 7.5% in the good-LIPI group (p = 0.02). Conclusions: LIPI identifies dMMR patients who do not benefit from ICI treatment, particularly fast-progressors. LIPI should be included as a stratification factor for future trials.
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Affiliation(s)
- Edouard Auclin
- Gastrointestinal and Medical Oncology Department, Hôpital Européen Georges Pompidou, Université de Paris, 75015 Paris, France; (E.A.); (J.T.)
| | - Perrine Vuagnat
- Early Drug Development Department, Institut Gustave Roussy, 94805 Villejuif, France; (P.V.); (C.S.); (Y.E.D.); (P.M.-R.); (C.M.); (A.H.)
| | - Cristina Smolenschi
- Early Drug Development Department, Institut Gustave Roussy, 94805 Villejuif, France; (P.V.); (C.S.); (Y.E.D.); (P.M.-R.); (C.M.); (A.H.)
| | - Julien Taieb
- Gastrointestinal and Medical Oncology Department, Hôpital Européen Georges Pompidou, Université de Paris, 75015 Paris, France; (E.A.); (J.T.)
| | - Jorge Adeva
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Imas 12, UCM, 28041 Madrid, Spain; (J.A.); (R.G.-C.)
| | - Laetitia Nebot-Bral
- UMR9019 Genome Integrity and Cancers, Gustave Roussy Cancer Campus, 94805 Villejuif, France;
- Paris Saclay, Paris Sud University Orsay, 91400 Orsay, France
| | - Marta Garcia de Herreros
- Medical Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; (M.G.d.H.); (L.G.); (T.S.); (H.O.)
| | - Rosario Vidal Tocino
- Medical Oncology Department, Hospital Universitario de Salamanca, IBSAL, 37007 Salamanca, Spain;
| | - Federico Longo-Muñoz
- Medical Oncology Department, Hospital Universitario Ramon y Cajal, IRYCIS, CIBERONC, 28034 Madrid, Spain;
| | - Yola El Dakdouki
- Early Drug Development Department, Institut Gustave Roussy, 94805 Villejuif, France; (P.V.); (C.S.); (Y.E.D.); (P.M.-R.); (C.M.); (A.H.)
| | - Patricia Martín-Romano
- Early Drug Development Department, Institut Gustave Roussy, 94805 Villejuif, France; (P.V.); (C.S.); (Y.E.D.); (P.M.-R.); (C.M.); (A.H.)
| | - Lydia Gaba
- Medical Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; (M.G.d.H.); (L.G.); (T.S.); (H.O.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain
| | - Tamara Saurí
- Medical Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; (M.G.d.H.); (L.G.); (T.S.); (H.O.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain
| | - Helena Oliveres
- Medical Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; (M.G.d.H.); (L.G.); (T.S.); (H.O.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain
| | | | - Rocio Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Imas 12, UCM, 28041 Madrid, Spain; (J.A.); (R.G.-C.)
| | - Benjamin Besse
- Medical Oncology, Institut Gustave Roussy, 94805 Villejuif, France;
| | - Christophe Massard
- Early Drug Development Department, Institut Gustave Roussy, 94805 Villejuif, France; (P.V.); (C.S.); (Y.E.D.); (P.M.-R.); (C.M.); (A.H.)
| | - Laura Mezquita
- Medical Oncology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; (M.G.d.H.); (L.G.); (T.S.); (H.O.)
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, 08036 Barcelona, Spain
- Medical Oncology, Institut Gustave Roussy, 94805 Villejuif, France;
| | - Antoine Hollebecque
- Early Drug Development Department, Institut Gustave Roussy, 94805 Villejuif, France; (P.V.); (C.S.); (Y.E.D.); (P.M.-R.); (C.M.); (A.H.)
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Berges-Gimeno MP, Carpio-Escalona LV, Longo-Muñoz F, Bernal-Rubio L, Lopez-Gonzalez P, Gehlhaar P, Pachon V, Ferreiro-Monteagudo R, Madrigal-Burgaleta R, Alvarez-Cuesta E. Does Rapid Drug Desensitization to Chemotherapy Affect Survival Outcomes? J Investig Allergol Clin Immunol 2021; 30:254-263. [PMID: 31188129 DOI: 10.18176/jiaci.0425] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Hypersensitivity reactions to oxaliplatin may affect prognosis by jeopardizing the timely completion of scheduled treatment sessions or by forcing reactive patients into unexpected changes in therapy. Rapid drug desensitization (RDD) enables these patients to receive their first-choice treatments safely. However, the possible effects of RDD on the efficacy of oxaliplatin have never been studied. Objective: The objective of this study was to evaluate the effect of RDD on survival rates in oxaliplatin-hypersensitive patients. METHODS We performed a 7-year retrospective study to compare survival between oxaliplatin-hypersensitive cases (patients receiving oxaliplatin by RDD) and nonallergic controls (patients receiving standard oxaliplatin infusions). The primary endpoint of this study was overall survival (OS) in cases and controls (Kaplan-Meier method with log-rank test comparisons). RESULTS OS was 23.7 months (95%CI, 15.3-30.9) for the 67 cases who underwent 337 RDDs, while for controls (n=143), OS was 34.5 months (95%CI, 21.7-55.5). There were no significant differences between the groups (HR, 1.42; 95%CI, 0.93-2.17; P =.104). CONCLUSIONS Survival outcomes of oxaliplatin-hypersensitive patients who received oxaliplatin via RDD did not differ significantly from those of control patients who received oxaliplatin via standard administration. Receiving oxaliplatin by means of RDD might be an effective therapeutic alternative for oxaliplatin-hypersensitive patients.
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Affiliation(s)
| | | | - F Longo-Muñoz
- Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
| | - L Bernal-Rubio
- Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
| | - P Lopez-Gonzalez
- Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
| | - P Gehlhaar
- Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
| | - V Pachon
- Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
| | | | | | - E Alvarez-Cuesta
- Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
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Carrato A, Abad A, Massuti B, Grávalos C, Escudero P, Longo-Muñoz F, Manzano JL, Gómez A, Safont MJ, Gallego J, García-Paredes B, Pericay C, Dueñas R, Rivera F, Losa F, Valladares-Ayerbes M, González E, Aranda E. First-line panitumumab plus FOLFOX4 or FOLFIRI in colorectal cancer with multiple or unresectable liver metastases: A randomised, phase II trial (PLANET-TTD). Eur J Cancer 2017. [PMID: 28633089 DOI: 10.1016/j.ejca.2017.04.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In first-line wild-type (WT)-Kirsten rat sarcoma viral oncogene homologue (KRAS) metastatic colorectal cancer (mCRC), panitumumab (Pmab) improves outcomes when added to FOLFOX [folinic acid, 5-fluorouracil, and oxaliplatin] or FOLFIRI [folinic acid, 5-fluorouracil, and irinotecan]. However no trial has directly compared these combinations. METHODS Multicentre, open-label study in untreated patients ≥ 18 years with (WT)-KRAS mCRC and multiple or unresectable liver-limited disease (LLD) randomised to either Pmab-FOLFOX4 or Pmab-FOLFIRI. The primary end-point was objective response rate (ORR). Secondary end-points included liver metastases resection rate (R0 + R1), progression-free survival (PFS), overall survival (OS), adverse events and perioperative safety. Exploratory end-points were: response by RAS status, early tumour shrinkage (ETS) and depth of response (DpR) in WT-RAS patients. RESULTS Data on 77 patients were analysed (38 Pmab-FOLFOX4; 39 Pmab-FOLFIRI; WT-RAS: 27/26, respectively). ORR was 74% with Pmab-FOLFOX4 and 67% with Pmab-FOLFIRI (WT-RAS: 78%/73%). Out of the above, 45% and 59% underwent surgical resection, respectively (WT-RAS: 37%/69%). The R0-R1 resection rate was 34%/46% (WT-RAS:26%/54%). Median PFS was 13/14 months (hazard ratio [HR] Pmab-FOLFIRI versus Pmab-FOLFOX4: 0.9; 95% confidence interval: [0.6-1.5]; WT-RAS:13/15; HR: 0.7 [0.4-1.3]). Median OS was 37/41 months (HR:1.0 [0.6-1.8]; WT-RAS: 39/49; HR:0.9 [0.4-1.9]). In WT-RAS patients with confirmed response, median DpR was 71%/66%, and 65%/77% of patients showed ETS ≥ 30%/ ≥ 20% at week 8, without significant differences between arms; these patients had longer median PFS and OS and higher resectability rates. Surgery was associated with longer survival. Perioperative and overall safety were similar, except for higher grade 3/4 neutropenia (40%/10%; p = 0.003) and neuropathy (13%/0%; p = 0.025) in the Pmab-FOLFOX4 arm. CONCLUSIONS In patients with WT-KRAS mCRC and LLD, both first-line Pmab-FOLFOX4 and Pmab-FOLFIRI resulted in high ORR and ETS, allowing potentially curative resection. No significant differences in efficacy were observed between the two regimens. (clinicaltrials.gov:NCT00885885).
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Affiliation(s)
- Alfredo Carrato
- Ramon y Cajal University Hospital, Ramon y Cajal Institute for Health Research - IRYCIS, Alcala University, CIBERONC, Carretera de Colmenar Viejo, km 9.100, ES-28034 Madrid, Spain.
| | - Albert Abad
- Germans Trias i Pujol Hospital-ICO, Carretera de Canyet s/n, ES-08916 Badalona, Spain
| | - Bartomeu Massuti
- Alicante General Hospital, Pintor Baeza, 11, ES-03010 Alicante, Spain
| | - Cristina Grávalos
- Doce de Octubre Hospital, Avenida de Córdoba, s/n, ES-28041 Madrid, Spain
| | - Pilar Escudero
- Clínico Lozano Blesa Hospital, Avenida San Juan Bosco, 15, ES-50009 Zaragoza, Spain
| | - Federico Longo-Muñoz
- Ramon y Cajal University Hospital, Ramon y Cajal Institute for Health Research - IRYCIS, Alcala University, CIBERONC, Carretera de Colmenar Viejo, km 9.100, ES-28034 Madrid, Spain
| | - José-Luis Manzano
- Germans Trias i Pujol Hospital-ICO, Carretera de Canyet s/n, ES-08916 Badalona, Spain
| | - Auxiliadora Gómez
- Maimonides Institute of Biomedical Research, IMIBIC, Spain, Reina Sofía Hospital, University of Córdoba, Spanish Cancer Network, (RTICC), Instituto de Salud Carlos III, Avenida Menéndez Pidal, s/n, ES-14004, Córdoba, Spain
| | - María José Safont
- Valencia General Hospital, Avenida Tres Cruces, 2, ES-46014 Valencia, Spain
| | - Javier Gallego
- Elche General University Hospital, Camí de l'Almazara, 11, ES-03203 Alicante, Spain
| | - Beatriz García-Paredes
- San Carlos Hospital, Calle del Professor Martín Lagos, S/N, ES-28040 Madrid, Center affiliated to the Red Temática de Investigación Cooperativa, RD06/0020/0021, Spain, Instituto Carlos III, Spanish Ministry of Science and Innovation, Madrid, Spain
| | - Carles Pericay
- Sabadell Hospital, Corporación Sanitaria Parc Taulí, Parc del Taulí, 1, ES-08208 Sabadell, Spain
| | - Rosario Dueñas
- Jaén Hospital Complex, Av. del Ejército Español, 10, ES-23007 Jaén, Spain
| | - Fernando Rivera
- Marqués de Valdecilla Hospital, Av. de Valdecilla, s/n, ES-39008 Santander, Spain
| | - Ferrán Losa
- L´Hospitalet General Hospital, Av. Josep Molins, 29, ES-08906 L´Hospitalet de Llobregat, Spain
| | | | - Encarnación González
- Virgen de las Nieves Hospital, Av. de las Fuerzas Armadas, 2, ES-18014 Granada, Spain
| | - Enrique Aranda
- Maimonides Institute of Biomedical Research, IMIBIC, Spain, Reina Sofía Hospital, University of Córdoba, Spanish Cancer Network, (RTICC), Instituto de Salud Carlos III, Avenida Menéndez Pidal, s/n, ES-14004, Córdoba, Spain
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6
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Longo-Muñoz F, Argiles G, Tabernero J, Cervantes A, Gravalos C, Pericay C, Gil-Calle S, Mizuguchi H, Carrato-Mena A, Limón ML, Garcia-Carbonero R. Efficacy of trifluridine and tipiracil (TAS-102) versus placebo, with supportive care, in a randomized, controlled trial of patients with metastatic colorectal cancer from Spain: results of a subgroup analysis of the phase 3 RECOURSE trial. Clin Transl Oncol 2016; 19:227-235. [PMID: 27443414 PMCID: PMC5239803 DOI: 10.1007/s12094-016-1528-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/20/2016] [Indexed: 11/28/2022]
Abstract
Purpose TAS-102 is a combination of the thymidine-based nucleoside analog trifluridine and the thymidine phosphorylase inhibitor tipiracil. Efficacy and safety of TAS-102 in patients with metastatic colorectal cancer (mCRC) refractory or intolerant to standard therapies were evaluated in the phase 3 RECOURSE trial. Results of RECOURSE demonstrated significant improvement in overall survival (OS) and progression-free survival (PFS) with TAS-102 versus placebo [hazard ratio (HR) = 0.68 and 0.48 for OS and PFS, respectively; both P < 0.001]. The current analysis evaluates efficacy and safety of TAS-102 in the RECOURSE Spanish subgroup. Methods Primary and key secondary endpoints were evaluated in a post hoc analysis of the RECOURSE Spanish subgroup, using univariate and multivariate analyses. Safety and tolerability were reported with descriptive statistics. Results The RECOURSE Spanish subgroup included 112 patients (mean age 61 years, 62 % male). Median OS was 6.8 months in the TAS-102 group (n = 80) versus 4.6 months in the placebo group (n = 32) [HR = 0.47; 95 % confidence interval (CI): 0.28–0.78; P = 0.0032). Median PFS was 2.0 months in the TAS-102 group and 1.7 months in the placebo group (HR = 0.47; 95 % CI: 0.30–0.74; P = 0.001). Eighty (100 %) TAS-102 versus 31 (96.9 %) placebo patients had adverse events (AEs). The most common drug-related ≥Grade 3 AE was neutropenia (40 % TAS-102 versus 0 % placebo). There was 1 (1.3 %) case of febrile neutropenia in the TAS-102 group versus none in the placebo group. Conclusions In the RECOURSE Spanish subgroup, TAS-102 was associated with significantly improved OS and PFS versus placebo, consistent with the overall RECOURSE population. No new safety signals were identified. ClinicalTrials.gov study number NCT01607957
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Affiliation(s)
- F Longo-Muñoz
- Hospital Universitario Ramón y Cajal, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Carretera de Colmenar Viejo Km 9.100, Madrid, Spain, 28034
| | - G Argiles
- Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), P. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - J Tabernero
- Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), P. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - A Cervantes
- Biomedical Research Institute INCLIVA, University of Valencia, Av. Menéndez Pelayo 4 accesorio, 46010, Valencia, Spain
| | - C Gravalos
- Hospital Universitario Doce de Octubre, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Avenida Cordoba km 5.4, Madrid, Spain, 28041
| | - C Pericay
- Hospital Universitario de Sabadell, Corporació Sanitària Parc Tauli, Parc Taulí, 1, 08208, Sabadell, Spain
| | - S Gil-Calle
- Hospital Carlos Haya, Av. de Carlos Haya, s/n, 29010, Málaga, Spain
| | - H Mizuguchi
- Taiho Oncology Inc, 202 Carnegie Center, Suite 100, Princeton, NJ, 08540, USA
| | - A Carrato-Mena
- Hospital Universitario Ramón y Cajal, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Carretera de Colmenar Viejo Km 9.100, Madrid, Spain, 28034
| | - M L Limón
- Hospital Universitario Virgen del Rocío, Sº Oncologia Medica, Manuel Siurot, 41013, Seville, Spain
| | - R Garcia-Carbonero
- Hospital Universitario Doce de Octubre, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Avenida Cordoba km 5.4, Madrid, Spain, 28041.
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