Shuji Arita1, Tsuyoshi Shirakawa2, Yuzo Matsushita3, Hozumi Kumagai Shimokawa4, Gen Hirano5, Akitaka Makiyama5, Yoshihiro Shibata6, Shingo Tamura7, Taito Esaki2, Kenji Mitsugi3, Hiroshi Ariyama4, Hitoshi Kusaba4, Koichi Akashi4, Eishi Baba8. 1. Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan. 2. Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan. 3. Department of Medical Oncology, Hamanomachi Hospital, Fukuoka, Japan. 4. Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan. 5. Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan. 6. Department of Chemotherapy, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan. 7. Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan. 8. Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan e-baba@c-oncology.med.kyushu-u.ac.jp.
Abstract
BACKGROUND: TAS-102 is an anti-metabolite which demonstrated activity against multidrug-resistant advanced colorectal cancer. Its major toxicities are hematological disorders. PATIENTS AND METHODS: Background, TAS-102 efficacy, toxicities and outcomes for patients with multidrug-resistant advanced colorectal cancer from six Institutions of the Kyushu Medical Oncology Group were retrospectively surveyed. RESULTS: Forty-three patients, including fragile patients due to declining performance status and other comorbidities (37%) were analyzed. Efficacy was reflected in an objective overall response of 3%, median progression-free survival of 74 days (2.5 months) and median overall survival of 229 days (7.6 months). The most frequent Common Terminology Criteria for Adverse Events grade 3/4 adverse events were neutropenia (44%), leukopenia (26%) and anemia (23%). Febrile neutropenia was found in 7%. Sub-group analysis demonstrated an improved outcome on treatment with the sequence regorafenib-TAS-102. CONCLUSION: TAS-102 was safely administered to modestly fragile patients with equivalent efficacy to that for the non-fragile population. Further investigation of sequential treatment using regorafenib and TAS-102 is needed. Copyright
BACKGROUND:TAS-102 is an anti-metabolite which demonstrated activity against multidrug-resistant advanced colorectal cancer. Its major toxicities are hematological disorders. PATIENTS AND METHODS: Background, TAS-102 efficacy, toxicities and outcomes for patients with multidrug-resistant advanced colorectal cancer from six Institutions of the Kyushu Medical Oncology Group were retrospectively surveyed. RESULTS: Forty-three patients, including fragilepatients due to declining performance status and other comorbidities (37%) were analyzed. Efficacy was reflected in an objective overall response of 3%, median progression-free survival of 74 days (2.5 months) and median overall survival of 229 days (7.6 months). The most frequent Common Terminology Criteria for Adverse Events grade 3/4 adverse events were neutropenia (44%), leukopenia (26%) and anemia (23%). Febrile neutropenia was found in 7%. Sub-group analysis demonstrated an improved outcome on treatment with the sequence regorafenib-TAS-102. CONCLUSION:TAS-102 was safely administered to modestly fragilepatients with equivalent efficacy to that for the non-fragile population. Further investigation of sequential treatment using regorafenib and TAS-102 is needed. Copyright