Decreased percentage of neutrophil is a predict factor for the efficacy of trifluridine and tipiracil hydrochloride for pretreated metastatic colorectal cancer

Makihara, Katsuya; Fukui, Rino; Uchiyama, Hideho; Shigeoka, Yasushi; Toyokawa, Akihiro

doi:10.21037/jgo.2019.04.04

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…On the other hand, the incidence of grade 3 or 4 CIN of FTD/TPI + Bev is higher than FTD/TPI monotherapy ( Tables VI and SIII ) ( 5 , 6 , 11 , 14 , 16 – 28 ). CIN was an independent predictive factor for the efficacy of FTD/TPI monotherapy, as reported previously ( 11 , 30 – 32 ). As mentioned before, pharmacokinetics and pharmacodynamics analysis in the RECOURSE trial suggests a dose-response relationship between FTD exposure and CIN, in agreement with the findings of the dose-escalation studies that a higher rate of CIN at higher doses of FTD/TPI leads to greater efficacy of the drug ( 10 ).…”

Section: Discussionsupporting

confidence: 86%

Effect of neutropenia on survival outcomes of patients with metastatic colorectal cancer receiving trifluridine/tipiracil plus bevacizumab

et al. 2021

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Trifluridine (FTD)/tipiracil (TPI) plus bevacizumab (Bev) is a promising late-line treatment in metastatic colorectal cancer (mCRC). Although chemotherapy-induced neutropenia (CIN) is a well-known predictor of FTD/TPI efficacy, whether CIN is a predictive marker of efficacy for FTD/TPI + Bev remains unclear. Thus, the present study aimed to investigate the clinical outcomes of FTD/TPI + Bev and the predictive markers of its efficacy. Clinical data of patients with mCRC who received FTD/TPI + Bev at the Cancer Institute Hospital between January 2017 and August 2020 were retrospectively collected. Disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and safety were assessed. In addition, subgroup analyses of prognostic and predictive efficacy markers were performed. In total, 94 patients (median age, 60.0 years; age range, 32–82 years; 37 men and 57 women) were included in the present study. The DCR was 44.7%, the median PFS time was 2.9 months (2.3–4.1 months) and the median OS time was 10.0 months (7.3–11.1 months). Grade 3 or 4 CIN within the first cycle of treatment occurred in 27.7% of patients, which was significantly associated with a longer PFS time than those who did not develop CIN [3.8 months (2.3–8.4 months) vs. 2.7 months (1.8–4.0 months); P=0.008]. Furthermore, the DCR was higher in patients with grade 3 or 4 CIN within the first cycle of treatment than those without CIN (61.5 vs. 38.2%; P=0.07). Multivariate Cox regression analysis revealed that grade 3 or 4 CIN within the first cycle of treatment are independent predictors for a longer PFS time (P=0.01). Taken together, the results of the present study suggest that grade 3 or 4 CIN within the first cycle of treatment are early predictors of the efficacy of FTD/TPI + Bev.

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Section: Discussionsupporting

confidence: 86%

Effect of neutropenia on survival outcomes of patients with metastatic colorectal cancer receiving trifluridine/tipiracil plus bevacizumab

et al. 2021

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“…The importance of grade 3 neutropenia as a predictive and prognostic marker in patients treated with trifluridine/tipiracil has been well established in the literature. [22][23][24][25] A recent post hoc pharmacokinetic/pharmacodynamic analysis of the RECOURSE study, attributed the development of treatment-induced neutropenia to a higher exposure to trifluridine and linked it to improved OS and PFS. 26 So far development of grade 3 neutropenia remains the most validated marker of response to trifluridine/tipiracil.…”

Section: Discussionmentioning

confidence: 99%

Trifluridine/Tipiracil in Metastatic Colorectal Cancer: A UK Multicenter Real-world Analysis on Efficacy, Safety, Predictive and Prognostic Factors

Stavraka

Pouptsis

Synowiec

et al. 2021

Clinical Colorectal Cancer

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“…Moreover, several inflammatory and nutritional scores using peripheral blood tests have been reported as useful prognostic factors in patients with mCRC treated with FTD/TPI. A retrospective study among 40 patients treated with FTD/TPI showed that a ≥25% decrease in neutrophils was an independent prognostic factor for OS (HR, 0.28; 95% CI, 0.12–0.72, p = 0.01) [ 26 ]. A single institutional retrospective study among 33 patients with mCRC treated with FTD/TPI revealed that a high neutrophil-to-lymphocyte ratio (NLR) was an independent prognostic factor for PFS in multivariate analysis (HR, 6.26; 95% CI, 1.99–19.74, p = 0.002) [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Effect of the C-Reactive Protein to Serum Albumin Ratio in Patients with Metastatic Gastric or Gastroesophageal Junction Cancer Treated with Trifluridine/Tipiracil

Hashimoto

Kano

Onuma

et al. 2023

JPM

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Trifluridine/tipiracil (FTD/TPI) is an oral anticancer agent used as a third- or later-line treatment for patients with metastatic gastric cancer/gastroesophageal junction cancer (mGC/GEJC). The C-reactive protein-to-serum albumin ratio (CAR) is an inflammation-based prognostic marker in gastric cancer. This retrospective study evaluated CAR’s clinical significance as a prognostic factor in 64 patients with mGC/GEJC administered FTD/TPI as a third- or later-line therapy. Patients were categorized into high- and low-CAR groups based on pre-treatment blood data. This study evaluated associations between CAR and overall survival (OS), progression-free survival (PFS), clinicopathological features, treatment efficacy, and adverse events. The high-CAR group had significantly worse Eastern Cooperative Oncology Group performance status, a higher prevalence of patients administered with a single course of FTD/TPI, and a higher rate of patients not administered chemotherapy after FTD/TPI therapy than the low-CAR group. Median OS and PFS were significantly poorer in the high-CAR group than in the low-CAR group (113 vs. 399 days; p < 0.001 and 39 vs. 112 days; p < 0.001, respectively). In multivariate analysis, high CAR was an independent prognostic factor for OS and PFS. The overall response rate was not significantly different between the high- and low-CAR groups. Regarding adverse events, the high-CAR group had a significantly lower incidence of neutropenia and a higher incidence of fatigue than the low-CAR group. Therefore, CAR may be a potentially useful prognostic factor for patients with mGC/GEJC treated with FTD/TPI as third- or later-line chemotherapy.

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Decreased percentage of neutrophil is a predict factor for the efficacy of trifluridine and tipiracil hydrochloride for pretreated metastatic colorectal cancer

Cited by 8 publications

References 20 publications

Effect of neutropenia on survival outcomes of patients with metastatic colorectal cancer receiving trifluridine/tipiracil plus bevacizumab

Effect of neutropenia on survival outcomes of patients with metastatic colorectal cancer receiving trifluridine/tipiracil plus bevacizumab

Trifluridine/Tipiracil in Metastatic Colorectal Cancer: A UK Multicenter Real-world Analysis on Efficacy, Safety, Predictive and Prognostic Factors

Clinical Effect of the C-Reactive Protein to Serum Albumin Ratio in Patients with Metastatic Gastric or Gastroesophageal Junction Cancer Treated with Trifluridine/Tipiracil

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