{"entity":{"id":"paper-sunlight-nejm-2023","kind":"paper","name":"SUNLIGHT: trifluridine-tipiracil plus bevacizumab in refractory metastatic colorectal cancer","aka":[],"tldr":"Adding bevacizumab to the oral chemotherapy trifluridine-tipiracil lengthened survival by about three months in patients with colorectal cancer that had already been treated with two regimens, making the combination the standard third-line treatment.","summary":"Phase 3 trial of 492 patients with metastatic colorectal cancer after two prior regimens randomised to trifluridine-tipiracil with or without bevacizumab.\n\nMedian overall survival was 10.8 versus 7.5 months (hazard ratio 0.61) and median progression-free survival 5.6 versus 2.4 months, with a longer time to worsening performance status and no unexpected toxicity.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2023","url":"https://doi.org/10.1056/NEJMoa2214963"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/37133585/"}],"tags":[],"related":[],"cancers":["kras-g12c-colorectal"],"sections":[],"technologies":[],"targets":[],"drugs":["bevacizumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["sunlight"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2023,"doi":"10.1056/NEJMoa2214963","pmid":"37133585","authors":"Prager GW, Taieb J, Fakih M, et al.","paperType":"rct","findings":["Median overall survival 10.8 vs 7.5 months; hazard ratio 0.61.","Median progression-free survival 5.6 vs 2.4 months."],"whatItMeans":"Trifluridine-tipiracil plus bevacizumab is now the preferred third-line option for most patients regardless of KRAS status, including KRAS G12C tumours once targeted therapy is exhausted.","caveats":["Open-label; benefit was seen regardless of prior bevacizumab exposure but subgroup sizes were limited."],"changedPractice":true,"participants":492},"route":"/key-papers/paper-sunlight-nejm-2023/","neighbours":{"cancer":[{"id":"kras-g12c-colorectal","kind":"cancer","name":"KRAS G12C-mutant colorectal cancer","route":"/cancers/kras-g12c-colorectal/"}],"drug":[{"id":"bevacizumab","kind":"drug","name":"Bevacizumab","route":"/drugs/bevacizumab/"}],"trial":[{"id":"sunlight","kind":"trial","name":"SUNLIGHT","route":"/trials/sunlight/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}