Assessing the Safety, Efficacy of Third-line Treatments for mCRC

A study assessed the safety and efficacy of third-line treatment regimens for metastatic colorectal cancer (mCRC). The findings appeared in Frontiers in Oncology.

The investigators conducted a comprehensive analysis and network meta-analysis (NMA) using data from the PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials databases between January 2005 and May 20, 2023. The analysis included 9 phase 2/3 randomized, controlled trials involving 5 treatment regimens.

The primary end point analyzed in the NMA was median overall survival (mOS). Secondary outcomes included median progression-free survival (PFS), disease control rate (DCR), and grade 3 or higher adverse events (AEs).

The study found that trifluridine/tipiracil (TAS-102) plus bevacizumab (hazard ratio [HR], 0.41; 95% credible interval [CrI], 0.32-0.52) was the most effective treatment for mOS compared with best supportive care (BSC). TAS-102 also showed a lower incidence of grade 3 or higher AEs compared with fruquintinib; however, fruquintinib demonstrated better improvement in DCR.

“TAS-102, fruquintinib, TAS-102 plus bevacizumab, the regorafenib standard-dose regimen (regorafenib), and the regorafenib dose-escalation regimen (regorafenib 80+) all demonstrated improved OS and PFS compared [with] BSC in mCRC patients. However, TAS-102 plus bevacizumab may be the optimal choice for third-line treatment in mCRC patients,” the researchers concluded.