The REWRITE Study – REal-WoRld effectIveness of TrifluridinE/tipiracil in Patients with Previously Treated Metastatic Colorectal Cancer
In the pivotal RECOURSE trial, trifluridine/tipiracil improved survival outcomes in refractory metastatic colorectal cancer (mCRC), while demonstrating an acceptable toxicity profile. Routine clinical practice evidence is important to support the ongoing value of recently approved medicines. Our obj...
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| Veröffentlicht in: | Clinical oncology (Royal College of Radiologists (Great Britain)) 2023-10, Vol.35 (10), p.665-672 |
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| creator | Marques, D. Costa, A.L. Mansinho, A. Quintela, A. Pratas, E. Brito-da-Silva, J. Cruz, J. Félix, J. Rodrigues, J. Mota, M. Teixeira, A.R. Dâmaso, S. Pinheiro, S. Andreozzi, V. Costa, L. Barros, A.G. |
| description | In the pivotal RECOURSE trial, trifluridine/tipiracil improved survival outcomes in refractory metastatic colorectal cancer (mCRC), while demonstrating an acceptable toxicity profile. Routine clinical practice evidence is important to support the ongoing value of recently approved medicines. Our objective was to assess the utilisation patterns and real-world effectiveness of trifluridine/tipiracil in previously treated mCRC patients.
This was a retrospective observational study including consecutive patients who started trifluridine/tipiracil between 1 April 2018 and 30 September 2019 in the medical oncology departments of three major public hospitals in Portugal. The primary outcome measure was overall survival. Associations between overall survival and patient and tumour characteristics were assessed using multivariate Cox regression analyses.
In total, 111 patients were included in the study, with a mean age of 64 years. From these, 45.9% received two prior lines of treatment, 47.8% had three or more previous lines of treatment and 83.6% had Eastern Cooperative Oncology Group (ECOG) performance status 0–1 at baseline. The median duration of trifluridine/tipiracil treatment was 3.7 cycles (95% confidence interval 3.4–4.1). Most patients (80.4%) remained on their planned dose throughout the trifluridine/tipiracil treatment period, fulfilling 100% relative dose intensity. The median overall survival in the total study cohort was 7.9 months (95% confidence interval 6.4–9.8) and the median progression-free survival was 3.4 months (95% confidence interval 3.2–3.9). The median overall survival was significantly higher in patients with a normal serum lactate dehydrogenase (LDH) level (median overall survival 11.2 months for [135, 205] IU/l LDH [95% confidence interval 8.2–NR] and 13.6 months for [205, 251] IU/l LDH [95% confidence interval 8.2–NR]) and in better fitted (ECOG = 0–1) patients (median overall survival 8.0 months; 95% confidence interval 6.7–10.0). The median time to worsening performance status was 6.2 months (95% confidence interval 5.0–8.0). Treatment discontinuation due to adverse events was low (3.1%).
Our study confirms the effectiveness of trifluridine/tipiracil in real-life mCRC patients. Overall survival and progression-free survival outcomes are consistent with the efficacy profile reported in the earlier randomised RECOURSE clinical trial. Like other real-world studies, we found no additional safety concerns in the use of trifluridine/ti |
| doi_str_mv | 10.1016/j.clon.2023.07.004 |
| format | Article |
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This was a retrospective observational study including consecutive patients who started trifluridine/tipiracil between 1 April 2018 and 30 September 2019 in the medical oncology departments of three major public hospitals in Portugal. The primary outcome measure was overall survival. Associations between overall survival and patient and tumour characteristics were assessed using multivariate Cox regression analyses.
In total, 111 patients were included in the study, with a mean age of 64 years. From these, 45.9% received two prior lines of treatment, 47.8% had three or more previous lines of treatment and 83.6% had Eastern Cooperative Oncology Group (ECOG) performance status 0–1 at baseline. The median duration of trifluridine/tipiracil treatment was 3.7 cycles (95% confidence interval 3.4–4.1). Most patients (80.4%) remained on their planned dose throughout the trifluridine/tipiracil treatment period, fulfilling 100% relative dose intensity. The median overall survival in the total study cohort was 7.9 months (95% confidence interval 6.4–9.8) and the median progression-free survival was 3.4 months (95% confidence interval 3.2–3.9). The median overall survival was significantly higher in patients with a normal serum lactate dehydrogenase (LDH) level (median overall survival 11.2 months for [135, 205] IU/l LDH [95% confidence interval 8.2–NR] and 13.6 months for [205, 251] IU/l LDH [95% confidence interval 8.2–NR]) and in better fitted (ECOG = 0–1) patients (median overall survival 8.0 months; 95% confidence interval 6.7–10.0). The median time to worsening performance status was 6.2 months (95% confidence interval 5.0–8.0). Treatment discontinuation due to adverse events was low (3.1%).
Our study confirms the effectiveness of trifluridine/tipiracil in real-life mCRC patients. Overall survival and progression-free survival outcomes are consistent with the efficacy profile reported in the earlier randomised RECOURSE clinical trial. Like other real-world studies, we found no additional safety concerns in the use of trifluridine/tipiracil.
•Trifluridine/tipiracil effectiveness confirmed in a Portuguese real-world study on mCRC patients.•Overall survival and PFS are consistent with the reported in earlier randomised clinical trials.•Survival impacted by timely trifluridine/tipiracil initiation and performance, RAS and LDH status.•Most patients remained on their initial dose, which confirms the good tolerability.•No additional safety concerns in the use of trifluridine/tipiracil were found.</description><identifier>ISSN: 0936-6555</identifier><identifier>EISSN: 1433-2981</identifier><identifier>DOI: 10.1016/j.clon.2023.07.004</identifier><identifier>PMID: 37487914</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Observational study ; overall survival ; progression-free survival ; real-world data ; trifluridine/tipiracil</subject><ispartof>Clinical oncology (Royal College of Radiologists (Great Britain)), 2023-10, Vol.35 (10), p.665-672</ispartof><rights>2023 The Authors</rights><rights>Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-c27be7caebfe08250b513a75679c054e08d89bf1822c685007ae9fb6f36ffed93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clon.2023.07.004$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37487914$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marques, D.</creatorcontrib><creatorcontrib>Costa, A.L.</creatorcontrib><creatorcontrib>Mansinho, A.</creatorcontrib><creatorcontrib>Quintela, A.</creatorcontrib><creatorcontrib>Pratas, E.</creatorcontrib><creatorcontrib>Brito-da-Silva, J.</creatorcontrib><creatorcontrib>Cruz, J.</creatorcontrib><creatorcontrib>Félix, J.</creatorcontrib><creatorcontrib>Rodrigues, J.</creatorcontrib><creatorcontrib>Mota, M.</creatorcontrib><creatorcontrib>Teixeira, A.R.</creatorcontrib><creatorcontrib>Dâmaso, S.</creatorcontrib><creatorcontrib>Pinheiro, S.</creatorcontrib><creatorcontrib>Andreozzi, V.</creatorcontrib><creatorcontrib>Costa, L.</creatorcontrib><creatorcontrib>Barros, A.G.</creatorcontrib><title>The REWRITE Study – REal-WoRld effectIveness of TrifluridinE/tipiracil in Patients with Previously Treated Metastatic Colorectal Cancer</title><title>Clinical oncology (Royal College of Radiologists (Great Britain))</title><addtitle>Clin Oncol (R Coll Radiol)</addtitle><description>In the pivotal RECOURSE trial, trifluridine/tipiracil improved survival outcomes in refractory metastatic colorectal cancer (mCRC), while demonstrating an acceptable toxicity profile. Routine clinical practice evidence is important to support the ongoing value of recently approved medicines. Our objective was to assess the utilisation patterns and real-world effectiveness of trifluridine/tipiracil in previously treated mCRC patients.
This was a retrospective observational study including consecutive patients who started trifluridine/tipiracil between 1 April 2018 and 30 September 2019 in the medical oncology departments of three major public hospitals in Portugal. The primary outcome measure was overall survival. Associations between overall survival and patient and tumour characteristics were assessed using multivariate Cox regression analyses.
In total, 111 patients were included in the study, with a mean age of 64 years. From these, 45.9% received two prior lines of treatment, 47.8% had three or more previous lines of treatment and 83.6% had Eastern Cooperative Oncology Group (ECOG) performance status 0–1 at baseline. The median duration of trifluridine/tipiracil treatment was 3.7 cycles (95% confidence interval 3.4–4.1). Most patients (80.4%) remained on their planned dose throughout the trifluridine/tipiracil treatment period, fulfilling 100% relative dose intensity. The median overall survival in the total study cohort was 7.9 months (95% confidence interval 6.4–9.8) and the median progression-free survival was 3.4 months (95% confidence interval 3.2–3.9). The median overall survival was significantly higher in patients with a normal serum lactate dehydrogenase (LDH) level (median overall survival 11.2 months for [135, 205] IU/l LDH [95% confidence interval 8.2–NR] and 13.6 months for [205, 251] IU/l LDH [95% confidence interval 8.2–NR]) and in better fitted (ECOG = 0–1) patients (median overall survival 8.0 months; 95% confidence interval 6.7–10.0). The median time to worsening performance status was 6.2 months (95% confidence interval 5.0–8.0). Treatment discontinuation due to adverse events was low (3.1%).
Our study confirms the effectiveness of trifluridine/tipiracil in real-life mCRC patients. Overall survival and progression-free survival outcomes are consistent with the efficacy profile reported in the earlier randomised RECOURSE clinical trial. Like other real-world studies, we found no additional safety concerns in the use of trifluridine/tipiracil.
•Trifluridine/tipiracil effectiveness confirmed in a Portuguese real-world study on mCRC patients.•Overall survival and PFS are consistent with the reported in earlier randomised clinical trials.•Survival impacted by timely trifluridine/tipiracil initiation and performance, RAS and LDH status.•Most patients remained on their initial dose, which confirms the good tolerability.•No additional safety concerns in the use of trifluridine/tipiracil were found.</description><subject>Observational study</subject><subject>overall survival</subject><subject>progression-free survival</subject><subject>real-world data</subject><subject>trifluridine/tipiracil</subject><issn>0936-6555</issn><issn>1433-2981</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kUFvEzEQhS0EoqHwBzggH7ns1vaud70SFxSFNlIRVQjq0fLaY9WRsxtsb6rcuPbcf8gvwVHaHjmNNPre08x7CH2kpKSENhebUvtxKBlhVUnakpD6FZrRuqoK1gn6Gs1IVzVFwzk_Q-9i3BBCmBDdW3RWtbVoO1rP0MP6DvBqcbtarhf4Z5rMAf_985g3yhe348obDNaCTss9DBAjHi1eB2f9FJxxw-IiuZ0LSjuP3YBvVHIwpIjvXbrDNwH2bpyiP2QJqAQGf4ekYsqUxvPRjyEbK4_natAQ3qM3VvkIH57mOfr1bbGeXxXXPy6X86_Xha44TYVmbQ-tVtBbIIJx0nNaqZY3bacJr_POiK63VDCmG8EJaRV0tm9s1eRHTFedo88n310Yf08Qk9y6qMF7NUC-VjJRUyFyvk1G2QnVYYwxgJW74LYqHCQl8liB3MhjBfJYgSStzBVk0acn_6nfgnmRPGeegS8nAPKXewdBRp1j02DcMRBpRvc__3-cB5pT</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Marques, D.</creator><creator>Costa, A.L.</creator><creator>Mansinho, A.</creator><creator>Quintela, A.</creator><creator>Pratas, E.</creator><creator>Brito-da-Silva, J.</creator><creator>Cruz, J.</creator><creator>Félix, J.</creator><creator>Rodrigues, J.</creator><creator>Mota, M.</creator><creator>Teixeira, A.R.</creator><creator>Dâmaso, S.</creator><creator>Pinheiro, S.</creator><creator>Andreozzi, V.</creator><creator>Costa, L.</creator><creator>Barros, A.G.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20231001</creationdate><title>The REWRITE Study – REal-WoRld effectIveness of TrifluridinE/tipiracil in Patients with Previously Treated Metastatic Colorectal Cancer</title><author>Marques, D. ; 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Routine clinical practice evidence is important to support the ongoing value of recently approved medicines. Our objective was to assess the utilisation patterns and real-world effectiveness of trifluridine/tipiracil in previously treated mCRC patients.
This was a retrospective observational study including consecutive patients who started trifluridine/tipiracil between 1 April 2018 and 30 September 2019 in the medical oncology departments of three major public hospitals in Portugal. The primary outcome measure was overall survival. Associations between overall survival and patient and tumour characteristics were assessed using multivariate Cox regression analyses.
In total, 111 patients were included in the study, with a mean age of 64 years. From these, 45.9% received two prior lines of treatment, 47.8% had three or more previous lines of treatment and 83.6% had Eastern Cooperative Oncology Group (ECOG) performance status 0–1 at baseline. The median duration of trifluridine/tipiracil treatment was 3.7 cycles (95% confidence interval 3.4–4.1). Most patients (80.4%) remained on their planned dose throughout the trifluridine/tipiracil treatment period, fulfilling 100% relative dose intensity. The median overall survival in the total study cohort was 7.9 months (95% confidence interval 6.4–9.8) and the median progression-free survival was 3.4 months (95% confidence interval 3.2–3.9). The median overall survival was significantly higher in patients with a normal serum lactate dehydrogenase (LDH) level (median overall survival 11.2 months for [135, 205] IU/l LDH [95% confidence interval 8.2–NR] and 13.6 months for [205, 251] IU/l LDH [95% confidence interval 8.2–NR]) and in better fitted (ECOG = 0–1) patients (median overall survival 8.0 months; 95% confidence interval 6.7–10.0). The median time to worsening performance status was 6.2 months (95% confidence interval 5.0–8.0). Treatment discontinuation due to adverse events was low (3.1%).
Our study confirms the effectiveness of trifluridine/tipiracil in real-life mCRC patients. Overall survival and progression-free survival outcomes are consistent with the efficacy profile reported in the earlier randomised RECOURSE clinical trial. Like other real-world studies, we found no additional safety concerns in the use of trifluridine/tipiracil.
•Trifluridine/tipiracil effectiveness confirmed in a Portuguese real-world study on mCRC patients.•Overall survival and PFS are consistent with the reported in earlier randomised clinical trials.•Survival impacted by timely trifluridine/tipiracil initiation and performance, RAS and LDH status.•Most patients remained on their initial dose, which confirms the good tolerability.•No additional safety concerns in the use of trifluridine/tipiracil were found.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37487914</pmid><doi>10.1016/j.clon.2023.07.004</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Observational study overall survival progression-free survival real-world data trifluridine/tipiracil |
| title | The REWRITE Study – REal-WoRld effectIveness of TrifluridinE/tipiracil in Patients with Previously Treated Metastatic Colorectal Cancer |
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