Abstract 73P
Background
Refractory metastatic colorectal cancer (mCRC) in older people is getting increasingly common as the world's elderly population grows. The aim of this real-world substudy was to assess the efficacy differences of sequential treatment with regorafenib (R) and trifluridine/tipiracil (T) and vice versa in younger patients (pts) and those aged 70 years or older. The endpoints were median overall survival (mOS), median progression-free survival (mPFS) and disease control rate (DCR).
Methods
Clinical data of pts with mCRC treated with R and T between 2012 and 2023, were retrospectively collected from 17 Italian cancer centers.
Results
1156 pts who received or sequential T and R and vice versa (T/R, n=261; R/T, n=155) or T (n=427) or R (n=313) only, were retrospectively enrolled. This substudy focused on 416 pts who were ≥70-year-old [122 (29.3%) and 59 (14.1%) pts in the T/R and R/T groups, respectively] and <70-year-old [139 (33.4%) and 96 (23%) pts treated with T/R and R/T, respectively]. We observed a statistically significant longer mOS and mPFS in ≥70-year-old pts treated with R/T [15.4 vs 11.6 months (HR=0,62; p=0,0058) and 11,3 vs 8,4 months (HR=0,47; p=< 0,0001) of ≥70-year-old pts treated with T/R, respectively]. In <70-year-old pts, we observed an improvement in mOS in R/T group vs T/R group (17,6 vs. 14,3 months; HR=0,78; p=0,1048) and, statistically significant, in mPFS (11,5 vs 8,5 months; HR=0,74; p=0,0323). Regarding DCR, we found a statistically significant benefit of 57,1% in favor of ≥70-year-old pts receiving R/T vs 30,1% of T/R sequence (p=0.0004); in younger than 70-year-pts, we observed an advantage of 48,9% in the R/T group vs 39,2% of the T/R sequence (p=0.2107).
Conclusions
According to our real-world subanalysis, the R/T sequence may improve survival and disease control in 3rd-line treatment and beyond for mCRC pts of any age. Treatment choices should, however, also take into account the pts characteristics, including sex, ECOG Performance Status, and metastatic sites. Anyway, further prospective research is needed to validate our results.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.