Authors (including presenting author) :
So HY (1)(2), You JHS (2), Yip YW (1), Wong SY (1)
Affiliation :
(1) Department of Pharmacy, Queen Mary Hospital, (2) School of Pharmacy, The Chinese University of Hong Kong
Keyword 1: :
Metastatic Colorectal Cancer
Keyword 2: :
Fruquintinib
Keyword 3: :
Trifluridine/Tipiracil
Keyword 4: :
Cohort study
Keyword 5: :
Survival outcome
Introduction :
Metastatic colorectal cancer (mCRC) is a leading cause of cancer-related mortality, with limited treatment options for refractory cases. Fruquintinib and trifluridine/tipiracil are approved for mCRC after standard therapies fail. However, direct evaluation of their efficacy and safety in real-world settings, particularly in Hong Kong, are lacking.
Objectives :
To evaluate the clinical outcomes of fruquintinib or trifluridine/tipiracil in mCRC patient.
Methodology :
This retrospective cohort study included 149 adult patients with mCRC who received fruquintinib or trifluridine/tipiracil at a tertiary hospital from 1/2021 to 12/2024. The outcomes included median overall survival (OS), median progression-free survival (PFS), time-to-treatment failure (TTF), and adverse events (AEs). Survival was analyzed using Kaplan-Meier methods and Cox proportional hazards models.
Result & Outcome :
Results A total of 149 patients (31 in fruquintinib group, 118 in trifluridine/tipiracil group) were included. Median OS was 6.93 months (95% CI: 3.84-10.02 months) for fruquintinib and 8.50 months (95% CI: 7.17-9.83 months) for trifluridine/tipiracil (hazard ratio [HR]: 1.07; 95% CI: 0.64-1.81; p = 0.782). There were no significant differences in median OS. No significant differences were also observed in median PFS (3.97 vs. 3.83 months; HR: 1.05; 95% CI: 0.65– 1.70; p = 0.849) or median TTF (2.77 vs. 2.67 months; HR: 1.02; 95% CI: 0.66–1.57; p = 0.941). Multivariate analysis revealed liver metastasis was associated with PFS (HR: 1.89; 95% CI: 1.24-2.87; p = 0.003). AEs occurred in 87.1% of patients in fruquintinib and 91.5% in trifluridine/tipiracil groups. The most common adverse events in the fruquintinib group included hypertension (n = 10; 32.3%) and hand-foot syndrome (n = 12; 38.7%) while anemia (n = 35; 29.7%) and neutropenia (n = 45; 38.1%) were most common in the trifluridine/tipiracil group. Conclusions: Fruquintinib and trifluridine/tipiracil demonstrated no statistically significant difference in median OS, median PFS and median TTF in refractory mCRC patients. With distinct toxicity profiles, treatment selection should consider patient-specific tolerability, emphasizing the need for personalized approaches in mCRC management.
