Abstract 89P
Background
Fruquintinib (Fru) is a VEGFR1/2/3 inhibitor approved for metastatic colorectal cancer (mCRC). Regorafenib (Reg) and TAS-102 have shown promise in mCRC treatment. This study evaluated the efficacy of Fru, Reg (monotherapy or combined with immune checkpoint inhibitors, ICIs), and TAS-102 with bevacizumab (Bev) in mCRC.
Methods
This retrospective study analyzed the efficacy across three cohorts among 418 mCRC patients: cohort 1 (168 patients) received Fru (98 patients) or Reg (70 patients) monotherapy, cohort 2 (171 patients) received Fru (104 patients) or Reg (67 patients) plus ICIs, and patients in cohort 3 (183 patients) received either Fru plus ICIs (104 patients) or TAS-102 plus Bev (79 patients). Propensity score matching (PSM) was utilized to minimize baseline differences. Through univariate and multivariate analyses, the study identified prognostic factors across cohorts, focusing on median overall survival (mOS) as the primary measure.
Results
Our study found that the mOS of Fru/Reg monotherapy, Fru/Reg combined with ICIs, TAS-102 combined with Bev was 11.3, 15.7, and 8.9 months, respectively, p= 0.00079. In cohort 1, pre- and post-matching mOS for Fru versus Reg monotherapy was 12.7 vs. 10.4 (HR= 0.679, p= 0.024) and 12.8 vs. 10.4 months (HR= 0.635, p= 0.009), respectively. In cohort 2, pre- and post-matching mOS for Fru with ICIs versus Reg with ICIs was 17.4 vs. 13.9 (HR= 0.588, p= 0.0081) and 23.6 vs. 13.9 months (HR= 0.544, p= 0.008), respectively. In cohort 3, pre- and post-matching mOS for Fru with ICIs versus TAS-102 with Bev was 17.4 vs. 8.9 (HR= 0.468, p＜0.0001) and 15.4 vs. 6.6 months (HR= 0.504, p= 0.003), respectively. Particularly, lung metastasis was a favorable prognostic factor in cohort 1. In cohort 2 and cohort 3, BRAF wild-type, single metastatic lesion and third-line treatment were favorable in both univariate and multivariate analyses.
Conclusions
In patients with metastatic colorectal cancer, the combination of Fru/Reg and ICIs showed superior efficacy than Fru/Reg monotherapy or TAS-102 plus Bev. Treatment with Fru, whether as monotherapy or in conjunction with ICIs, surpassed other therapeutic options, consistent with observations from real-world clinical practice.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.