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Adding a cheap old antibody to the refractory-line tablet took median survival from 7.5 to 10.8 months, the largest gain in this setting since the setting existed.
Prager, Taieb, Fakih and colleagues randomly assigned, 1:1, adult patients who had received no more than two previous chemotherapy regimens for advanced colorectal cancer to trifluridine-tipiracil plus bevacizumab or trifluridine-tipiracil alone, with overall survival as the primary end point and progression-free survival and safety, including time to worsening of ECOG performance status from 0 or 1 to 2 or more, as secondary end points. A total of 246 patients were assigned to each group.
The commonest adverse events in both groups were neutropenia, nausea and anaemia; no treatment-related deaths were reported.
Trifluridine-tipiracil with bevacizumab is the refractory-line standard, and a reminder that combining two drugs already on the shelf can beat anything new in the same line.
A third refractory-line option, and the clearest example in colorectal cancer of a drug developed and approved in China going on to a global registration trial.
Trifluridine-tipiracil became the other refractory-line standard alongside regorafenib, and the backbone that SUNLIGHT later improved on by adding bevacizumab.
Shares Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2), Randomized trial of TAS-102 for refractory metastatic colorectal cancer (RECOURSE), Eric Van Cutsem, VEGF / VEGFR and the tag colorectal-evidence.
Shares Josep Tabernero, Eric Van Cutsem, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, New England Journal of Medicine and the tag colorectal-evidence.
Shares Josep Tabernero, Eric Van Cutsem, VEGF / VEGFR, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation and the tag colorectal-evidence.
Shares Josep Tabernero, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, New England Journal of Medicine, Cytotoxic chemotherapy and the tag colorectal-evidence.
Shares VEGF / VEGFR, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Anti-angiogenic therapy, Bevacizumab and the tag colorectal-evidence.
Shares VEGF / VEGFR, Anti-angiogenic therapy, Bevacizumab, Cytotoxic chemotherapy and the tag colorectal-evidence.
Shares VEGF / VEGFR, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Anti-angiogenic therapy, Bevacizumab and the tag colorectal-evidence.
Shares Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, New England Journal of Medicine, Cytotoxic chemotherapy, Colorectal cancer and the tag colorectal-evidence.