Outcomes of Patients with Metastatic Colorectal Cancer Treated with Trifluridine/Tipiracil beyond the Second Line: A Multicenter Retrospective Study from Saudi Arabia

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Abstract

Background

The outcome of patients with refractory metastatic colorectal cancer (mCRC) treated with trifluridine/tipiracil (FTD/TPI) beyond the second-line has not been studied in Saudi Arabia. Therefore, this multicenter retrospective analysis was conducted to evaluate the efficacy of FTD/TPI.

Methods

This multicenter retrospective analysis included five centers in Saudi Arabia. FTD/TPI was administered to all the patients beyond the oxaliplatin- and irinotecan-based chemotherapy regimens. The electronic medical records were reviewed, and progression-free survival (PFS) and overall survival (OS) were determined.

Results

The study included 100 patients with a mean age of 55.4 ± 11.8 years. The overall response to FTD/TPI was 4%. The median PFS was 4 months (95% confidence interval (CI) 3.487–4.513), and the median OS was 11 months (95% CI, 9.226–12.771). In a Cox regression analysis of the independent predictors for PFS, advanced stage of the disease ( P = 0.037; HR, 2.614; and CI, 1.102–7.524), presence of lymph node metastasis ( P = 0.018; HR, 3.664; and 95% CI, 1.187–8.650), and >2 metastatic sites ( P = 0.020; HR, 1.723; and 95% CI, 1.089–2.727) were independent factors predicting disease progression. The Cox regression analysis confirmed that age ≥ 55 years ( P = 0.046; HR, 1.667; and 95%, 1.097–3.100), advanced disease stage ( P = 0.044; HR, 1.283; and 95% CI, 1.035–2.940), prior use of adjuvant chemotherapy ( P = 0.037; HR, 0.892; and 95% CI, 0.481–0.994), liver metastasis ( P = 0.025; HR, 2.015; and 95% CI, 1.091–3.720), >2 metastatic sites ( P = 0.038; HR, 1.248; and 95% CI, 1.036–1.846), development of neutropenia after receiving first cycle of FTD/TPI ( P = 0.042; HR, 1.505; and 95% CI, 1.064–2.167), and increased number of FTD/TPI cycles ( P = 0.002; HR, 0.769; and 95% CI, 0.664–0.891) were independent variables for OS.

Conclusion

Treatment with FTD/TPI is feasible and effective in daily clinical practice in Saudi Arabian patients. The risk of progression increased with advanced disease stage, lymph node metastasis, bone metastasis, and metastasis to >2 sites. Age ≥ 55 years, advanced disease stage, liver metastasis, metastasis to >2 sites, neutropenia after the first cycle of FTD/TPI, and increased number of FTD/TPI cycles were independent factors predicting mortality.

Related collections

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Author and article information

Contributors

Nashwa Abdel-Aziz:

ORCID: https://orcid.org/0000-0002-1701-9248

Journal

Journal ID (nlm-ta): J Oncol

Journal ID (iso-abbrev): J Oncol

Journal ID (publisher-id): jo

Title: Journal of Oncology

Publisher: Hindawi

ISSN (Print): 1687-8450

ISSN (Electronic): 1687-8469

Publication date Collection: 2022

Publication date (Electronic): 12 September 2022

Volume: 2022

Electronic Location Identifier: 3796783

Affiliations

¹Department of Medical Oncology, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia

²Department of Medical Oncology, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

³Oncology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

⁴Department of Internal Medicine, Section of Medical Oncology, Security Forces Hospital, Riyadh, Saudi Arabia

⁵Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

⁶Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt

⁷Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia

⁸Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

⁹Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt

¹⁰Oncology Center, Mansoura University, Mansoura, Egypt

Author notes

Academic Editor: Jayaprakash Kolla

Author information

Ahmed Mostafa Gad https://orcid.org/0000-0003-3179-9989

Nashwa Abdel-Aziz https://orcid.org/0000-0002-1701-9248

Article

DOI: 10.1155/2022/3796783

PMC ID: 9485708

SO-VID: 5168fef3-62c6-44a0-880f-a056ccd65933

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Outcomes of Patients with Metastatic Colorectal Cancer Treated with Trifluridine/Tipiracil beyond the Second Line: A Multicenter Retrospective Study from Saudi Arabia

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