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首页> 美国卫生研究院文献>Molecular and Clinical Oncology >Combination chemotherapy with TAS-102 plus bevacizumab in salvage-line treatment of metastatic colorectal cancer: A single-center retrospective study examining the prognostic value of the modified Glasgow Prognostic Score in salvage-line therapy of metastatic colorectal cancer
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Combination chemotherapy with TAS-102 plus bevacizumab in salvage-line treatment of metastatic colorectal cancer: A single-center retrospective study examining the prognostic value of the modified Glasgow Prognostic Score in salvage-line therapy of metastatic colorectal cancer

机译：TAS-102联合贝伐单抗联合化疗在转移性结直肠癌抢救治疗中的单中心回顾性研究探讨改良的格拉斯哥预后评分在转移性结直肠癌抢救治疗中的预后价值

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The combination regimen of TAS-102, a novel oral nucleoside antitumor agent containing trifluridine and tipiracil hydrochloride, with bevacizumab (C-TASK FORCE), a selective monoclonal antibody inhibitor of vascular endothelial growth factor-A, as salvage-line therapy for metastatic colorectal cancer (mCRC) was established based on its high clinical effectiveness. The aim of the present study was to evaluate the prognostic accuracy of the modified Glasgow Prognostic Score (mGPS) in patients receiving TAS-102 plus bevacizumab. The study included 17 patients (12 men and 5 women, mean age 60.4±13.4 years) with unresectable mCRC who were confirmed to have wild-type or mutant RAS genes. The patients received salvage-line treatment with TAS-102 plus bevacizumab at the Surgical Oncology Department of Gifu University School of Medicine between March 2016 and August 2018. The study population was heavily pretreated; the majority of the patients (71%) had received ≥4 prior regimens and, in addition to fluoropyrimidine, irinotecan and oxaliplatin, all had received bevacizumab (100%) and either cetuximab or panitumumab (47%). The RAS status was wild-type in 9 (53%) and mutant in 8 (47%) patients. The primary tumor locations included the right-sided colon in 5 patients (29%; cecum in 2 and transverse colon in 3 cases) and left-sided colorectum in 12 patients [71%; sigmoid colon in 4, rectosigmoid (Rs) in 4, and rectum above/below the peritoneal reflection (Ra/b) in 4 cases]. Metastatic sites included the liver in 15 (88%), lung in 13 (76%), lymph nodes in 7 (41%), and peritoneal dissemination in 5 (24%) patients. The number of metastatic sites was 1 in 3 (18%) and >2 in 14 (82%) patients. Their first staging imaging scans (after 2 cycles of therapy) were available for review in all 17 patients. At first evaluation, 5 (29%) patients had progressive disease (PD), 12 (71%) had stable disease, and none had a partial response to TAS-102 plus bevacizumab. The median overall survival (OS) of 14.1 months and progression-free survival (PFS) of 6.8 months were comparable to the 11.2 and 5.6 months, respectively, in the C-TASK FORCE study. Upon considering three groups, namely mGPS 0, mGPS 1 and mGPS 2, the median PFS times were significantly different (mGPS 0 vs. mGPS 2, P=0.02; and mGPS 1 vs. mGPS 2, P=0.06). The median PFS times in the mGPS 0, 1 and 2 groups were 12.1, 4.8 and 2.3 months, respectively. Median OS was also significantly different (mGPS 0 vs. mGPS 2, P=0.01; and mGPS 1 vs. mGPS 2, P=0.04). The median OS times in the mGPS 0, 1 and 2 groups were 14.0, not reached, and 2 months, respectively. The present study demonstrated the efficacy and safety of the TAS-102 plus bevacizumab combination as salvage-line treatment. This combination therapy (the TAS-102 plus bevacizumab) has obtained valid results with PFS OS as well as C-TASK.FORCE study. The results of the present study also confirmed the prognostic accuracy of mGPS in salvage-line treatment of patients with mCRC.
机译：TAS-102是一种新型口服核苷类抗肿瘤药，其中含有三氟吡啶和盐酸替吡酯，与贝伐单抗（C-TASK FORCE）（血管内皮生长因子-A的选择性单克隆抗体抑制剂）联合使用，作为转移性结直肠癌的抢救性疗法癌症（mCRC）的建立基于其高度的临床效果。本研究的目的是评估改良的格拉斯哥预后评分（mGPS）在接受TAS-102加贝伐单抗治疗的患者中的预后准确性。该研究包括17例无法切除的mCRC患者（12例男性和5例女性，平均年龄60.4±13.4岁），这些患者被证实具有野生型或突变RAS基因。患者于2016年3月至2018年8月在岐阜大学医学院外科肿瘤学系接受了TAS-102加贝伐单抗的挽救性治疗。大多数患者（71％）接受过≥4种既往治疗方案，除氟嘧啶，伊立替康和奥沙利铂外，均接受贝伐单抗（100％）和西妥昔单抗或帕尼单抗（47％）。 RAS状态为9（53％）是野生型，突变为8（47％）。原发肿瘤的位置包括5例患者的右侧结肠（29％；盲肠2例，横结肠3例）和左侧结直肠癌12例[71％；乙状结肠4例，乙状结肠（Rs）4例，直肠上/下腹膜反射（Ra / b）4例]。转移部位包括肝癌（15％（88％），肺癌13％（76％），淋巴结肿大7％（41％）和腹膜扩散（5％（24％））。转移部位的数量为三分之一（18％），> 2个部位（14％（82％））。他们的第一次分期成像扫描（2个疗程后）可供所有17例患者复查。初次评估时，有5名（29％）的患者患有进行性疾病（PD），有12名（71％）的患者患有稳定的疾病，没有人对TAS-102加贝伐单抗有部分反应。在C-TASK FORCE研究中，中位总生存期（OS）为14.1个月，无进展生存期（PFS）为11.2和5.6个月。考虑三个组，即mGPS 0，mGPS 1和mGPS 2，中值PFS时间显着不同（mGPS 0与mGPS 2，P = 0.02； mGPS 1与mGPS 2，P = 0.06）。 mGPS 0、1和2组的中位PFS时间分别为12.1、4.8和2.3个月。 OS中位数也显着不同（mGPS 0与mGPS 2，P = 0.01； mGPS 1与mGPS 2，P = 0.04）。 mGPS 0、1和2组的中位OS时间分别为14.0（未达到）和2个月。本研究证明了TAS-102加贝伐单抗联合作为抢救治疗的有效性和安全性。这种联合疗法（TAS-102加贝伐单抗）在PFS OS以及C-TASK.FORCE研究中均获得了有效的结果。本研究结果还证实了mGPS在mCRC抢救治疗中的预后准确性。

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