TAS-102 and regorafenib were shown to have clinical activity in a large population of Japanese and Western patients with heavily pretreated advanced colorectal cancer. Median OS and PFS of TAS-102 were reported 7.1 and 2.0 months, and median OS and PFS of regorafenib were 6.4 and 1.9 months for refractory colorectal cancer. We usually treated TAS-102 and regorafenib for refractory colorectal cancer at late-line. However whether TAS-102 or regorafenib should be first is not clear. So we assessed efficacy and safety of TAS-102 and regorafenib for refractory metastatic colorectal cancer at retrospective.
We selected patients with advanced colorectal cancer treated both TAS-102 and regorafenib between June 2014 and October 2017 in our institution. TAS-102 (with each dose consisting of 35 mg per square meter) was administered twice daily, 5 days a week, with 2 days of rest, for 2 weeks, followed by a 14-day rest period, thus completing one treatment cycle. Regorafenib was administered 160 mg once daily for the first 3 weeks of each 4-week cycle.
21 patients were treated of TAS-102 followed by regorafenib (TR) and 11 patients were treated of regorafenib followed by TAS-102 (RT). The median age of TR and RT were 63 and 60 years. Performance status of 1 and 2 for TR were 17 and 4, RT were 7 and 4 patients. All patients had received prior chemotherapy containing a fluoropyrimidine, oxaliplatin, and irinotecan. Response rate of TR and RT were 4% and 0%, disease control rate of TR and RT were14% and 18%. Median PFS of TR and RT were 54 days (95%CI 18-136) and 50 days (95%CI 25-167). Median OS of TR and RT were 237 days (95%CI 70-645) and 242 days (95%CI 79-405). Treatment discontinuation due to adverse events was more frequent in regorafenib phase.
There were no significant differences of effectiveness for TAS-102 followed by regorafenib or the reverse sequence in advanced colorectal cancer.
Haruko Daga Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan.
Has not received any funding.
All authors have declared no conflicts of interest.