학술논문
Clinical Impact of Primary Tumor Location in Metastatic Colorectal Cancer Patients Under Later-Line Regorafenib or Trifluridine/Tipiracil Treatment
Document Type
article
Author
Hiromichi Nakajima; Shota Fukuoka; Toshiki Masuishi; Atsuo Takashima; Yosuke Kumekawa; Takeshi Kajiwara; Kentaro Yamazaki; Yuji Negoro; Masato Komoda; Akitaka Makiyama; Tadamichi Denda; Yukimasa Hatachi; Takeshi Suto; Naotoshi Sugimoto; Masanobu Enomoto; Toshiaki Ishikawa; Tomomi Kashiwada; Koji Ando; Satoshi Yuki; Hiroyuki Okuyama; Hitoshi Kusaba; Daisuke Sakai; Koichi Okamoto; Takao Tamura; Kimihiro Yamashita; Masahiko Gosho; Toshikazu Moriwaki
Source
Frontiers in Oncology, Vol 11 (2021)
Subject
Language
English
ISSN
2234-943X
Abstract
BackgroundPrimary tumor location (PTL) is an important prognostic and predictive factor in the first-line treatment of metastatic colorectal cancer (mCRC). Although regorafenib (REG) and trifluridine/tipiracil (FTD/TPI) have been introduced recently, the clinical impact of PTL in these treatments is not well understood.Materials and MethodsWe retrospectively evaluated patients with mCRC who were registered in a multicenter observational study (the REGOTAS study). The main inclusion criteria were Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–2, refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, angiogenesis inhibitors, anti-epidermal growth factor receptor therapy (if RAS wild-type), and no prior use of REG and FTD/TPI. The impact of PTL on overall survival (OS) was evaluated using Cox proportional hazard models based on baseline characteristics.ResultsA total of 550 patients (223 patients in the REG group and 327 patients in the FTD/TPI group) were included in this study, with 122 patients with right-sided tumors and 428 patients with left-sided tumors. Although the right-sided patients had significantly shorter OS compared with the left-sided patients by univariate analysis (p = 0.041), a multivariate analysis revealed that PTL was not an independent prognostic factor (hazard ratio, 0.95; p = 0.64). In a subgroup analysis, the OS was comparable between the REG and FTD/TPI groups regardless of PTL (p for interactions = 0.60).ConclusionsIn the present study, PTL is not a prognostic and predictive factor in patients with mCRC under later-line REG or FTD/TPI therapy.