Abstract 2663
Background
The oral chemotherapy trifluridine/tipiracil (FTD/TPI or TAS-102) is approved for treatment of previously treated mCRC patients (pts) beyond the second line, in the same setting as regorafenib. Optimal treatment sequencing between the two at this stage is not established. Here, a descriptive post hoc sub-group analysis assessed safety and efficacy of FTD/TPI in mCRC pts according to previous treatment with regorafenib in a preliminary analysis of the phase 3b PRECONNECT study (NCT03306394).
Methods
PRECONNECT is enrolling pts with histologically confirmed mCRC previously treated with available therapies, with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0/1. Pts receive oral FTD/TPI (35 mg/m2 bid) on days 1–5 and 8–12 of each 28-day cycle. Of the 462 patients who received at least one dose at cutoff (1 Nov 2017), 166 (36%) were pretreated with regorafenib.
Results
Patient subgroups pretreated (n = 166) and non-pretreated (n = 296) with regorafenib were broadly similar, with a slight imbalance for RAS mutant status (61% vs 47%), left-sided tumour (58% vs 65%) and treatment line (12% vs 36% receiving FTD/TPI third line), respectively. There was no difference in rate of emergent or drug-related any grade adverse events (AEs), or drug-related grade ≥3 AEs in pts treated with FTD/TPI between the regorafenib pretreated and regorafenib non-pretreated subgroups (98% vs 96%; 77% vs 79%; and 54% vs 51%, respectively). The most common drug-related grade ≥3 AEs were neutropenia (43% vs 40%) and anemia (8% vs 7%). Median FTD/TPI treatment duration were 2.7 and 3.1 months, with a median PFS of 2.7 (95% CI 2.2-3.3) and 3.3 months (95% CI 2.8-3.7), disease control rate was 38% (95% CI 30–46) and 43% (95% CI 37-49) and median time to ECOG-PS ≥2 was 8.5 and 8.7 months in the regorafenib pretreated and regorafenib non-pretreated, respectively.
Conclusions
FTD/TPI may be used either before or after regorafenib with similar efficacy results making treatment safety profile and patient quality of life major points to determine treatment option in third-line for mCRC patients.
Clinical trial identification
EudraCT: 2016-002311-18.
Legal entity responsible for the study
Laboratoires Servier.
Funding
Laboratoires Servier.
Editorial Acknowledgement
Not applicable
Disclosure
J. Taieb: Honoraria speaker or advisory role: Servier, Roche, Lilly, Celgene, Shire, Amgen, Sanofi, Merck, Lilly, Sirtex. A. Falcone: Compensation for participation Advisory Boards, Research Grants to institution: Amgen, Bayer, Merck, MSD, Roche, Lilly, Servier, Bristol. S. Lonardi: Consulting or advisory role: Amgen, Bayer, Merck, Lilly; Speakers' bureau: Lilly; Roche, BMS; Research funding: Amgen. T.J. Price: Advisory board: Amgen (paid self), Merck, Roche, Takeda (paid self). J-B. Bachet: Honoraria: Amgen, Bayer, Celgene, Merck Serono, Roche, Shire, Servier. L. Wyrwicz: Funding or fees: Halozyme, Eisai, Merck. F. Ciardiello: Advisory board role: Servier, Merck, Roche, Amgen, Bayer, Symphogen. M. Becquart, N. Mounedji: Employee: Servier. E. Van Cutsem: Grants: Amgen, Bayer, BMS, Boehringer, Celgene, Ipsen, Lilly, Merck, MSD, Novartis, Roche, Servier; Honoraria: Bayer, BMS, Celgene, Lilly, Novartis, Servier.