Efficacy and safety of trifluridine/tipiracil in older and younger patients with metastatic gastric or gastroesophageal junction cancer: subgroup analysis of a randomized phase 3 study (TAGS)

Background Trifluridine and tipiracil (FTD/TPI) demonstrated survival benefit vs placebo and manageable safety in previously treated patients with metastatic gastric/gastroesophageal junction cancer (mGC/GEJC) in the randomized, placebo-controlled, phase 3 TAGS study. This subgroup analysis of TAGS...

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Veröffentlicht in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2022-05, Vol.25 (3), p.586-597
Hauptverfasser: Shitara, Kohei, Doi, Toshihiko, Hosaka, Hisashi, Thuss-Patience, Peter, Santoro, Armando, Longo, Federico, Ozyilkan, Ozgur, Cicin, Irfan, Park, David, Zaanan, Aziz, Pericay, Carles, Özgüroğlu, Mustafa, Alsina, Maria, Makris, Lukas, Benhadji, Karim A., Ilson, David H.
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container_title Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
container_volume 25
creator Shitara, Kohei
Doi, Toshihiko
Hosaka, Hisashi
Thuss-Patience, Peter
Santoro, Armando
Longo, Federico
Ozyilkan, Ozgur
Cicin, Irfan
Park, David
Zaanan, Aziz
Pericay, Carles
Özgüroğlu, Mustafa
Alsina, Maria
Makris, Lukas
Benhadji, Karim A.
Ilson, David H.
description Background Trifluridine and tipiracil (FTD/TPI) demonstrated survival benefit vs placebo and manageable safety in previously treated patients with metastatic gastric/gastroesophageal junction cancer (mGC/GEJC) in the randomized, placebo-controlled, phase 3 TAGS study. This subgroup analysis of TAGS examined efficacy/safety outcomes by age. Methods In TAGS, patients with mGC/GEJC and ≥ 2 prior therapies were randomized (2:1) to receive FTD/TPI 35 mg/m 2 or placebo, plus best supportive care. A preplanned subgroup analysis was performed to evaluate efficacy and safety outcomes in patients aged 
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This subgroup analysis of TAGS examined efficacy/safety outcomes by age. Methods In TAGS, patients with mGC/GEJC and ≥ 2 prior therapies were randomized (2:1) to receive FTD/TPI 35 mg/m 2 or placebo, plus best supportive care. A preplanned subgroup analysis was performed to evaluate efficacy and safety outcomes in patients aged &lt; 65, ≥ 65, and ≥ 75 years. Results Among 507 randomized patients ( n  = 337 FTD/TPI; n  = 170 placebo), 55%, 45%, and 14% were aged &lt; 65, ≥ 65, and ≥ 75 years, respectively. Overall survival hazard ratios for FTD/TPI vs placebo were 0.67 (95% CI 0.51–0.89), 0.73 (95% CI 0.52–1.02), and 0.67 (95% CI 0.33–1.37) in patients aged &lt; 65, ≥ 65, and ≥ 75 years, respectively. Regardless of age, patients receiving FTD/TPI experienced improved progression-free survival and stayed longer on treatment than those receiving placebo. Among FTD/TPI-treated patients, frequencies of any-cause grade ≥ 3 adverse events (AEs) were similar across age subgroups (80% each), although grade ≥ 3 neutropenia was more frequent in older patients [40% (≥ 65 and ≥ 75 years); 29% (&lt; 65 years)]; AE-related discontinuation rates did not increase with age [14% (&lt; 65 years), 12% (≥ 65 years), and 12% (≥ 75 years)]. Conclusions The results of this subgroup analysis show the efficacy and tolerability of FTD/TPI treatment regardless of age in patients with mGC/GEJC who had received 2 or more prior treatments.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-021-01271-9</identifier><identifier>PMID: 34997449</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Abdominal Surgery ; Age ; Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antiviral drugs ; Cancer Research ; Colorectal Neoplasms - pathology ; Drug Combinations ; Esophageal Neoplasms - drug therapy ; Esophagogastric Junction - pathology ; Frontotemporal dementia ; Frontotemporal Dementia - chemically induced ; Frontotemporal Dementia - drug therapy ; Gastric cancer ; Gastroenterology ; Humans ; Medicine ; Medicine &amp; Public Health ; Metastases ; Metastasis ; Neutropenia ; Oncology ; Original ; Original Article ; Patients ; Placebos ; Pyrrolidines ; Safety ; Stomach Neoplasms - pathology ; Surgical Oncology ; Survival ; Thymine ; Trifluridine - adverse effects</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2022-05, Vol.25 (3), p.586-597</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-b0cf0ac69d50b88a60fbb723fcfbbc68be4cae387e2c7bf3a13a7aafeb1d03e3</citedby><cites>FETCH-LOGICAL-c498t-b0cf0ac69d50b88a60fbb723fcfbbc68be4cae387e2c7bf3a13a7aafeb1d03e3</cites><orcidid>0000-0001-5196-3630</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-021-01271-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-021-01271-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34997449$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shitara, Kohei</creatorcontrib><creatorcontrib>Doi, Toshihiko</creatorcontrib><creatorcontrib>Hosaka, Hisashi</creatorcontrib><creatorcontrib>Thuss-Patience, Peter</creatorcontrib><creatorcontrib>Santoro, Armando</creatorcontrib><creatorcontrib>Longo, Federico</creatorcontrib><creatorcontrib>Ozyilkan, Ozgur</creatorcontrib><creatorcontrib>Cicin, Irfan</creatorcontrib><creatorcontrib>Park, David</creatorcontrib><creatorcontrib>Zaanan, Aziz</creatorcontrib><creatorcontrib>Pericay, Carles</creatorcontrib><creatorcontrib>Özgüroğlu, Mustafa</creatorcontrib><creatorcontrib>Alsina, Maria</creatorcontrib><creatorcontrib>Makris, Lukas</creatorcontrib><creatorcontrib>Benhadji, Karim A.</creatorcontrib><creatorcontrib>Ilson, David H.</creatorcontrib><title>Efficacy and safety of trifluridine/tipiracil in older and younger patients with metastatic gastric or gastroesophageal junction cancer: subgroup analysis of a randomized phase 3 study (TAGS)</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background Trifluridine and tipiracil (FTD/TPI) demonstrated survival benefit vs placebo and manageable safety in previously treated patients with metastatic gastric/gastroesophageal junction cancer (mGC/GEJC) in the randomized, placebo-controlled, phase 3 TAGS study. This subgroup analysis of TAGS examined efficacy/safety outcomes by age. Methods In TAGS, patients with mGC/GEJC and ≥ 2 prior therapies were randomized (2:1) to receive FTD/TPI 35 mg/m 2 or placebo, plus best supportive care. A preplanned subgroup analysis was performed to evaluate efficacy and safety outcomes in patients aged &lt; 65, ≥ 65, and ≥ 75 years. Results Among 507 randomized patients ( n  = 337 FTD/TPI; n  = 170 placebo), 55%, 45%, and 14% were aged &lt; 65, ≥ 65, and ≥ 75 years, respectively. Overall survival hazard ratios for FTD/TPI vs placebo were 0.67 (95% CI 0.51–0.89), 0.73 (95% CI 0.52–1.02), and 0.67 (95% CI 0.33–1.37) in patients aged &lt; 65, ≥ 65, and ≥ 75 years, respectively. Regardless of age, patients receiving FTD/TPI experienced improved progression-free survival and stayed longer on treatment than those receiving placebo. Among FTD/TPI-treated patients, frequencies of any-cause grade ≥ 3 adverse events (AEs) were similar across age subgroups (80% each), although grade ≥ 3 neutropenia was more frequent in older patients [40% (≥ 65 and ≥ 75 years); 29% (&lt; 65 years)]; AE-related discontinuation rates did not increase with age [14% (&lt; 65 years), 12% (≥ 65 years), and 12% (≥ 75 years)]. Conclusions The results of this subgroup analysis show the efficacy and tolerability of FTD/TPI treatment regardless of age in patients with mGC/GEJC who had received 2 or more prior treatments.</description><subject>Abdominal Surgery</subject><subject>Age</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antiviral drugs</subject><subject>Cancer Research</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Drug Combinations</subject><subject>Esophageal Neoplasms - drug therapy</subject><subject>Esophagogastric Junction - pathology</subject><subject>Frontotemporal dementia</subject><subject>Frontotemporal Dementia - chemically induced</subject><subject>Frontotemporal Dementia - drug therapy</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Neutropenia</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Placebos</subject><subject>Pyrrolidines</subject><subject>Safety</subject><subject>Stomach Neoplasms - pathology</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Thymine</subject><subject>Trifluridine - adverse effects</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UsluFDEQbSEQWeAHOCBLXJJDEy-9mQNSFIWAFIkDc7eq3XaPRz124wXU_By_hiedhOXAqZ5cr14tfkXxiuC3BOP2IhBMKC4xJWUGLSn5k-KYVKwpGcP10wdMOTkqTkLYYUxqTprnxRGrOG-rih8XP6-1NhLkgsAOKIBWcUFOo-iNnpI3g7HqIprZeJBmQsYiNw3K37EXl-yY8QzRKBsD-m7iFu1VhBDzk0RjBj5H51foVHDzFkYFE9olK6NxFkmwUvl3KKR-9C7NWRqmJZhwGAOQz53c3vxQA8qlQSGGQkzDgs42lzdfzl8UzzRMQb28j6fF5sP15upjefv55tPV5W0pK97FssdSY5ANH2rcdx00WPd9S5mWOcqm61UlQbGuVVS2vWZAGLSQr9GTATPFTov3q-yc-r0aZF7XwyRmb_bgF-HAiL8z1mzF6L4JjgljtMsCZ_cC3n1NKkSxN0GqaQKrXAqCNqSjtGa8zdQ3_1B3Lvl8lAOrJqTijDeZRVeW9C4Er_TjMASLgz3Eag-R7SHu7CF4Lnr95xqPJQ9-yAS2EkJOHT73d-__yP4C6bPMpw</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Shitara, Kohei</creator><creator>Doi, Toshihiko</creator><creator>Hosaka, Hisashi</creator><creator>Thuss-Patience, Peter</creator><creator>Santoro, Armando</creator><creator>Longo, Federico</creator><creator>Ozyilkan, Ozgur</creator><creator>Cicin, Irfan</creator><creator>Park, David</creator><creator>Zaanan, Aziz</creator><creator>Pericay, Carles</creator><creator>Özgüroğlu, Mustafa</creator><creator>Alsina, Maria</creator><creator>Makris, Lukas</creator><creator>Benhadji, Karim A.</creator><creator>Ilson, David H.</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5196-3630</orcidid></search><sort><creationdate>20220501</creationdate><title>Efficacy and safety of trifluridine/tipiracil in older and younger patients with metastatic gastric or gastroesophageal junction cancer: subgroup analysis of a randomized phase 3 study (TAGS)</title><author>Shitara, Kohei ; Doi, Toshihiko ; Hosaka, Hisashi ; Thuss-Patience, Peter ; Santoro, Armando ; Longo, Federico ; Ozyilkan, Ozgur ; Cicin, Irfan ; Park, David ; Zaanan, Aziz ; Pericay, Carles ; Özgüroğlu, Mustafa ; Alsina, Maria ; Makris, Lukas ; Benhadji, Karim A. ; Ilson, David H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c498t-b0cf0ac69d50b88a60fbb723fcfbbc68be4cae387e2c7bf3a13a7aafeb1d03e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Age</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antiviral drugs</topic><topic>Cancer Research</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Drug Combinations</topic><topic>Esophageal Neoplasms - drug therapy</topic><topic>Esophagogastric Junction - pathology</topic><topic>Frontotemporal dementia</topic><topic>Frontotemporal Dementia - chemically induced</topic><topic>Frontotemporal Dementia - drug therapy</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine &amp; 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Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shitara, Kohei</au><au>Doi, Toshihiko</au><au>Hosaka, Hisashi</au><au>Thuss-Patience, Peter</au><au>Santoro, Armando</au><au>Longo, Federico</au><au>Ozyilkan, Ozgur</au><au>Cicin, Irfan</au><au>Park, David</au><au>Zaanan, Aziz</au><au>Pericay, Carles</au><au>Özgüroğlu, Mustafa</au><au>Alsina, Maria</au><au>Makris, Lukas</au><au>Benhadji, Karim A.</au><au>Ilson, David H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of trifluridine/tipiracil in older and younger patients with metastatic gastric or gastroesophageal junction cancer: subgroup analysis of a randomized phase 3 study (TAGS)</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>25</volume><issue>3</issue><spage>586</spage><epage>597</epage><pages>586-597</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background Trifluridine and tipiracil (FTD/TPI) demonstrated survival benefit vs placebo and manageable safety in previously treated patients with metastatic gastric/gastroesophageal junction cancer (mGC/GEJC) in the randomized, placebo-controlled, phase 3 TAGS study. This subgroup analysis of TAGS examined efficacy/safety outcomes by age. Methods In TAGS, patients with mGC/GEJC and ≥ 2 prior therapies were randomized (2:1) to receive FTD/TPI 35 mg/m 2 or placebo, plus best supportive care. A preplanned subgroup analysis was performed to evaluate efficacy and safety outcomes in patients aged &lt; 65, ≥ 65, and ≥ 75 years. Results Among 507 randomized patients ( n  = 337 FTD/TPI; n  = 170 placebo), 55%, 45%, and 14% were aged &lt; 65, ≥ 65, and ≥ 75 years, respectively. Overall survival hazard ratios for FTD/TPI vs placebo were 0.67 (95% CI 0.51–0.89), 0.73 (95% CI 0.52–1.02), and 0.67 (95% CI 0.33–1.37) in patients aged &lt; 65, ≥ 65, and ≥ 75 years, respectively. Regardless of age, patients receiving FTD/TPI experienced improved progression-free survival and stayed longer on treatment than those receiving placebo. Among FTD/TPI-treated patients, frequencies of any-cause grade ≥ 3 adverse events (AEs) were similar across age subgroups (80% each), although grade ≥ 3 neutropenia was more frequent in older patients [40% (≥ 65 and ≥ 75 years); 29% (&lt; 65 years)]; AE-related discontinuation rates did not increase with age [14% (&lt; 65 years), 12% (≥ 65 years), and 12% (≥ 75 years)]. Conclusions The results of this subgroup analysis show the efficacy and tolerability of FTD/TPI treatment regardless of age in patients with mGC/GEJC who had received 2 or more prior treatments.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>34997449</pmid><doi>10.1007/s10120-021-01271-9</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-5196-3630</orcidid><oa>free_for_read</oa></addata></record>
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subjects Abdominal Surgery
Age
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antiviral drugs
Cancer Research
Colorectal Neoplasms - pathology
Drug Combinations
Esophageal Neoplasms - drug therapy
Esophagogastric Junction - pathology
Frontotemporal dementia
Frontotemporal Dementia - chemically induced
Frontotemporal Dementia - drug therapy
Gastric cancer
Gastroenterology
Humans
Medicine
Medicine & Public Health
Metastases
Metastasis
Neutropenia
Oncology
Original
Original Article
Patients
Placebos
Pyrrolidines
Safety
Stomach Neoplasms - pathology
Surgical Oncology
Survival
Thymine
Trifluridine - adverse effects
title Efficacy and safety of trifluridine/tipiracil in older and younger patients with metastatic gastric or gastroesophageal junction cancer: subgroup analysis of a randomized phase 3 study (TAGS)
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