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 |
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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 |
doi_str_mv | 10.1007/s10120-021-01271-9 |
format | Article |
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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 < 65, ≥ 65, and ≥ 75 years.
Results
Among 507 randomized patients (
n
= 337 FTD/TPI;
n
= 170 placebo), 55%, 45%, and 14% were aged < 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 < 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% (< 65 years)]; AE-related discontinuation rates did not increase with age [14% (< 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 & 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 < 65, ≥ 65, and ≥ 75 years.
Results
Among 507 randomized patients (
n
= 337 FTD/TPI;
n
= 170 placebo), 55%, 45%, and 14% were aged < 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 < 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% (< 65 years)]; AE-related discontinuation rates did not increase with age [14% (< 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 & 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 & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Neutropenia</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Placebos</topic><topic>Pyrrolidines</topic><topic>Safety</topic><topic>Stomach Neoplasms - pathology</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Thymine</topic><topic>Trifluridine - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & 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 < 65, ≥ 65, and ≥ 75 years.
Results
Among 507 randomized patients (
n
= 337 FTD/TPI;
n
= 170 placebo), 55%, 45%, and 14% were aged < 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 < 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% (< 65 years)]; AE-related discontinuation rates did not increase with age [14% (< 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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language | eng |
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source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
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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