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01-09-2020 | Neutropenia | Original Article

Neutropenia is an indicator of outcomes in metastatic colorectal cancer patients treated with FTD/TPI plus bevacizumab: a retrospective study

Authors: Yohei Nose, Yoshinori Kagawa, Taishi Hata, Ryota Mori, Kenji Kawai, Atsushi Naito, Takuya Sakamoto, Kohei Murakami, Yoshiteru Katsura, Yoshiaki Ohmura, Toru Masuzawa, Atsushi Takeno, Yutaka Takeda, Takeshi Kato, Kohei Murata

Published in: Cancer Chemotherapy and Pharmacology | Issue 3/2020

Abstract

Purpose

Trifluridine/tipiracil (FTD/TPI) improves the overall survival (OS) of metastatic colorectal cancer (mCRC) patients. Additionally, FTD/TPI plus bevacizumab (BEV) has demonstrated promising efficacy for mCRC patients who are refractory to standard chemotherapy. Chemotherapy-induced neutropenia (CIN) has been reported to be an indicator of efficacy for FTD/TPI. This study investigated whether CIN was an indicator of efficacy for FTD/TPI plus BEV.

Methods

We reviewed chemo-refractory mCRC patients who were treated with FTD/TPI alone (monotherapy) or FTD/TPI plus BEV (combination) at our institution and compared the safety and efficacy of the two. Progression-free survival (PFS) and OS were analyzed using Kaplan–Meier curves. We also investigated correlations between CIN and outcomes.

Results

In total, 56 patients received FTD/TPI, among whom 24 and 32 were treated with monotherapy and combination therapy, respectively. The median PFS was 1.8 and 4.7 months for the monotherapy and combination arms, respectively (hazard ratio [HR]: 0.28; 95% confidence interval [CI]: 0.15–0.51; P < 0.001). The median OS was 6.3 and 11.7 months for the monotherapy and combination arms, respectively (HR 0.25; 95% CI 0.13–0.48; P < 0.001). CIN (Grade 3 or worse) developed in five (20.8%) and 17 (53.1%) patients from the monotherapy and combination arms, respectively (P = 0.030). Patients with CIN in the combination arm had improved PFS and OS compared with non-CIN patients (P = 0.033 and P = 0.045, respectively).

Conclusions

FTD/TPI plus BEV prolonged PFS and OS and had tolerable toxicity compared with FTD/TPI alone. CIN is an indicator of patients who will benefit from FTD/TPI plus BEV.

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Title: Neutropenia is an indicator of outcomes in metastatic colorectal cancer patients treated with FTD/TPI plus bevacizumab: a retrospective study
Authors: Yohei Nose
Yoshinori Kagawa
Taishi Hata
Ryota Mori
Kenji Kawai
Atsushi Naito
Takuya Sakamoto
Kohei Murakami
Yoshiteru Katsura
Yoshiaki Ohmura
Toru Masuzawa
Atsushi Takeno
Yutaka Takeda
Takeshi Kato
Kohei Murata
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keywords: Neutropenia
Bevacizumab
Colorectal Cancer
Colorectal Cancer
Cytostatic Therapy
Published in: Cancer Chemotherapy and Pharmacology / Issue 3/2020
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-020-04129-6

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