Review of metastatic colorectal cancer treatment pathways and early clinical experience of trifluridine/tipiracil in the UK named patient programme
Affiliation
University Hospital Southampton NHS Foundation Trust, Southampton, UKIssue Date
2020
Metadata
Show full item recordAbstract
BACKGROUND: The standard first- and second- line chemotherapy backbone regimens for metastatic colorectal cancer (mCRC) are 5-fluorouracil (5-FU)/capecitabine-based with addition of irinotecan or oxaliplatin. Until recently, evidence for optimal sequencing post second-line was sparse. Trifluridine/tipiracil (indicated for mCRC and gastric cancer after standard chemotherapies) was made available to UK patients via a named patient programme (NPP) before receiving marketing authorisation in Europe in 2016, allowing characterisation of UK treatment pathways, and evaluation of trifluridine/tipiracil in a UK non-trial population. METHODS: Data collected routinely for the NPP were analysed to describe the patient demographics, clinical characteristics and treatment pathways. Patients eligible for the programme were adults (?18?years) with histologically or cytologically confirmed mCRC who had previously received chemotherapy treatment(s). RESULTS: Of the 250 eligible patients enrolled in the NPP, 194 patients received ?1 dose of trifluridine/tipiracil and 56 patients did not receive trifluridine/tipiracil. The following results are reported first for patients who received trifluridine/tipiracil and second for those who did not receive trifluridine/tipiracil: median (IQR) age was 63.0 (54.0-69.0) and 62.0 (54.8-69.0) years; Eastern Cooperative Oncology Group performance status score was 0 for 28 and 14%, 1 for 65 and 70%, 2 for 7 and 16%. In terms of previous systemic treatments 47 and 43% had 2 prior lines of therapy. FOLFOX-, FOLFIRI- and CAPOX-based therapies were the most common first-line regimens in patients receiving trifluridine/tipiracil (37, 35 and 21%, respectively), and in patients not receiving trifluridine/tipiracil (41, 30 and 20%, respectively). Second-line treatment regimens in patients receiving and not receiving trifluridine/tipiracil were most commonly FOLFIRI-based (48 and 41%, respectively) and FOLFOX-based (19 and 21%, respectively). Patients received a median of 2?cycles of trifluridine/tipiracil with a median treatment duration of 1.8 (95% CI: 1.8-2.4) months. In patients who discontinued treatment due to disease progression, the median progression-free duration was 2.8 (95% CI: 2.4-2.9) months. CONCLUSIONS: The results highlight the number of treatment pathways used to treat mCRC in routine UK clinical practice prior to the marketing authorisation and National Institute for Health and Care Excellence approval of trifluridine/tipiracil and highlight the lack of clinical guidelines for mCRC.Citation
Iveson T, Carter AM, Shiu KK, Spooner C, Stevens D, Mullamitha S. Review of metastatic colorectal cancer treatment pathways and early clinical experience of trifluridine/tipiracil in the UK named patient programme. BMC Cancer. 2020;20(1):91.Journal
BMC CancerDOI
10.1186/s12885-020-6577-1PubMed ID
32013902Additional Links
https://dx.doi.org/10.1186/s12885-020-6577-1Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1186/s12885-020-6577-1
Scopus Count
Collections
Related articles
- Trifluridine/tipiracil: A practical guide to its use in the management of refractory metastatic colorectal cancer in Australia.
- Authors: Price T, Burge M, Chantrill L, Gibbs P, Pavlakis N, Shapiro J, Sjoquist K
- Issue date: 2020 Apr
- Retrospective cohort study of trifluridine/tipiracil (TAS-102) plus bevacizumab versus trifluridine/tipiracil monotherapy for metastatic colorectal cancer.
- Authors: Kotani D, Kuboki Y, Horasawa S, Kaneko A, Nakamura Y, Kawazoe A, Bando H, Taniguchi H, Shitara K, Kojima T, Tsuji A, Yoshino T
- Issue date: 2019 Dec 27
- Real-world use of trifluridine/tipiracil for patients with metastatic colorectal cancer in Canada.
- Authors: Samawi HH, Brezden-Masley C, Afzal AR, Cheung WY, Dolley A
- Issue date: 2019 Oct
- Long-Term Progression-Free Survival of a Pre-Treated Patient with Metastatic Colorectal Cancer Receiving Trifluridine/Tipiracil.
- Authors: Michl GM, Vogt FM, Nouriani A, Ladurner R, Kremer M, Reisländer T, Michl M
- Issue date: 2024
- The safety and efficacy of trifluridine-tipiracil for metastatic colorectal cancer: A pharmacy perspective.
- Authors: Chan BM, Hochster HS, Lenz HJ
- Issue date: 2019 Feb 21