Abstract 428P
Background
Colorectal cancer (CRC) is the fifth most common cancer and one of the leading causes of cancer-related death in China. Although apatinib and S-1, respectively, are used in the treatment of advanced colorectal cancer, the efficacy and safety of the combination of the two drugs are unclear. The aim of this study was to investigate the efficacy and safety of low-dose apatinib plus S-1 compared with regorafenib and fruquintinib in patients with metastatic colorectal cancer (mCRC) refractory to standard therapies.
Methods
Records of 114 patients with refractory mCRC in our center from April 2016 to 17 September 2020 were retrospectively reviewed. Among these patients, 43 received apatinib 250mg/day combined with S-1, 36 received regorafenib starting at 80mg/day with weekly escalation, and 35 received fruquintinib.
Results
The median progression-free survival was 3.9 months [95% confidence interval (CI),2.5-5.3 months] in the apatinib plus S-1 group, 3.1 months (95% CI 1.9-4.2 months) in the fruquintinib group, and 2.4 months (95% CI 2.1-2.7 months) in the regorafenib group, the mPFS of apatinib plus S-1 was significantly longer than that of regorafenib. The median overall survival was 8.2 months (95%CI，5.4-11.0 months) in the apatinib plus S-1 group, 7.8 months (95%CI，5.3-10.3 months) in the fruquintinib group, and 7.5 months (95%CI, 4.2-10.7 months) in the regorafenib group, which was comparable among the three groups. Disease control rate (DCR) was 83.7% in the apatinib plus S-1 group, 71.4% in the fruquintinib group, and 66.7% in the regorafenib group, and no significant difference was shown among the three groups. Patients in the apatinib plus S-1 group had a higher incidence of hematological toxicity including anemia, leukopenia, and thrombocytopenia, and the hand-foot skin reaction was more prevalent in the regorafenib group, while the adverse reaction of hypertension in the fruquintinib group was very significant.
Conclusions
Low-dose apatinib plus S-1 prolonged PFS compared with regorafenib, and is a promising clinical regimen for the treatment of refractory mCRC with tolerable and controlled toxicity that is worth studying in the future.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hong Qiu.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.