TAS-102 improves overall survival in metastatic colorectal cancer
Study to determine the effects of a novel drug on survival rate
In this pooled, retrospective cohort study, available data on neutropenia counts were analysed from 149 patients with refractory metastatic colorectal cancer who were treated with a novel combination oral nucleoside antitumour agent called TAS-102 (trifluridine and tipiracil hydrochloride).
The patient records were reviewed from four institutions: three North American and one comparative validation population from Japan.
The aim of the study was to determine the effect of the drug on overall survival, focusing on the predictive value of developing chemotherapy-induced neutropenia (CIN), as defined by the Common Terminology Criteria for Adverse Events, at one month.
Overall, 46% of patients developed CIN (greater than or equal to grade 2) at one month after initiation of the treatment, and this was associated with a benefit to overall prognosis. The patients who developed this degree of CIN were found to have had significantly longer progression-free survival (3.0 vs 2.4 months) and overall survival (14.0 vs 5.6 months).
There was no significant difference or influence of different demographic characteristics, such as gender or age, nor clinical characteristics, such as the location of the primary tumour or the status of genetic mutation.
The authors acknowledge the important implications of these findings for clinical practice, where almost counterintuitively, the dosage of such drugs could be amplified in patients not experiencing any neutropenia to improve outcomes.
Kasi P, Kotani D, Cecchini M et al (2016) Chemotherapy induced neutropenia at 1-month mark is a predictor of overall survival in patients receiving TAS-102 for refractory metastatic colorectal cancer: a cohort study. BMC Cancer. 16:467. doi: 10.1186/s12885-016-2491-y.