Phase II Study of Irinotecan, Trifluridine/tipiracil (TAS-102) plus Bevacizumab as a Later-line Therapy for Patients with Metastatic Colorectal Cancer (mCRC): a prospective single-center explorative study

Br J Cancer. 2024 Dec;131(11):1775-1780. doi: 10.1038/s41416-024-02885-3. Epub 2024 Oct 24.

Abstract

Purpose: To explore the efficacy and safety of the combination of irinotecan, trifluridine/tipiracil (TAS-102), and bevacizumab in a later-line setting for metastatic colorectal cancer (mCRC) patients.

Patients and methods: This was a single-center, phase II trial. The mCRC patients who are refractory to standard first-line and second-line treatment are eligible. Patients who previously received irinotecan while progressing during maintenance therapy are also eligible. The primary endpoint was the objective response rate (ORR).

Results: Between August 1, 2022, and September 30, 2023, 35 patients were enrolled, and 31 of them were evaluable for efficacy. The ORR was 25.8% (8/31), and the disease control rate (DCR) was 93.5% (29/31). As of April 30, 2024, the median progression-free survival (PFS) was 9.2 months (95% CI 6.285-12.115), whereas the median overall survival (OS) was not reached with the 1-year OS rate of 73.5%. The most common grade 3/4 treatment-related adverse events were neutropenia (34.3%), anemia (17.1%), and thrombocytopenia (8.6%).

Conclusion: Irinotecan, TAS-102 plus bevacizumab regimen preliminarily demonstrated promising efficacy with tolerable toxicity for mCRC patients as later-line treatment. This regimen warrants further exploration in refractory mCRC patients.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Bevacizumab* / administration & dosage
  • Bevacizumab* / adverse effects
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / pathology
  • Drug Combinations*
  • Female
  • Humans
  • Irinotecan* / administration & dosage
  • Irinotecan* / adverse effects
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Progression-Free Survival
  • Prospective Studies
  • Pyrrolidines* / administration & dosage
  • Pyrrolidines* / adverse effects
  • Pyrrolidines* / therapeutic use
  • Thymine* / administration & dosage
  • Trifluridine* / administration & dosage
  • Trifluridine* / adverse effects
  • Trifluridine* / therapeutic use
  • Uracil* / administration & dosage
  • Uracil* / analogs & derivatives
  • Uracil* / therapeutic use

Substances

  • Bevacizumab
  • Trifluridine
  • Thymine
  • Irinotecan
  • Pyrrolidines
  • trifluridine tipiracil drug combination
  • Drug Combinations
  • Uracil