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.
Highlights
The present study retrospectively examined the clinical records of patients with metastatic colorectal cancer (mCRC) treated with later-line REG or FTD/TPI chemotherapy during the period from June 1, 2014, to November 30, 2015
No interactions were observed between the treatment groups and primary tumor location (PTL) in terms of overall survival (OS) and progression-free survival (PFS), which suggests that the efficacy of REG and FTD/TPI is not influenced by PTL
Our multicenter retrospective study revealed that PTL is not a prognostic factor in patients with mCRC under later-line REG or FTD/TPI treatment
Summary
Accumulating evidence indicates that primary tumor location (PTL) is an important prognostic factor in mCRC, as right-sided tumors are associated with poorer outcomes than left-sided tumors, especially after first-line treatments [13,14,15,16,17]. The clinical impact of PTL in patients with mCRC under later-line REG or FTD/TPI treatment is not well understood. Primary tumor location (PTL) is an important prognostic and predictive factor in the first-line treatment of metastatic colorectal cancer (mCRC). Regorafenib (REG) and trifluridine/tipiracil (FTD/TPI) have been introduced recently, the clinical impact of PTL in these treatments is not well understood
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