The Journal of Practical Medicine >

2023 , Vol. 39 >Issue 18: 2389 - 2394

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.18.018

Drugs and Clinic Practice

The clinical value of PD1 inhibitor combined with furoquantinib and TAS⁃102 posterior therapy for advanced colorectal cancer

  • Xiaoqin SU ,
  • Xi CHEN ,
  • Haihua FAN ,
  • Congfei JI ,
  • Tingting NI ,
  • Yang YU ,
  • Jia. CHEN
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  • Department of Oncology，Affiliated Tumour Hospital of Nantong University，Nantong 226361，China

Received date: 2023-07-19

  Online published: 2023-10-10

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Abstract

Objective To explore the clinical value and safety of PDI inhibitor combined with furoquantinib and TAS-102 in the treatment of advanced colorectal cancer. Methods This study is a retrospective analysis， collected a total of 30 late stage colorectal cancer cases that failed standard treatment. Among the 30 case， 12 cases were set as the observation group， and 18 cases were set as the control group. The observation group was treated with PD1 inhibitor combined with furoquantinib and TAS-102， while the control group was treated with PD1 inhibitor combined with furoquantinib. PD1 inhibitors include Xindilizumab 200 mg， Tirelizumab 200 mg， or Sepalizumab 240 ng. 3 ~ 5 mg Furoquantinib is received orally for two weeks and stopped for one week. TAS-102 （25 mg/m2） was taken orally after breakfast and dinner on days 1 to 5 and 8 to 12， with a cycle of 21 days. Data were organized data to analyze the objective response rate （ORR）， disease control rate （DCR）， adverse reactions of the two groups， and patients were regularly followed up to observe their progression free survival （PFS）. Results Until the end of follow-up （March 20， 2023）， the ORR and DCR of the control group were 11.11%， 33.33%， and the median PFS was 6.2 months. The objective response rate of the observation group was 25.00%， white DCR was 83.33%， and median PF was 8.6 months. There was no significant difference in 0RR between the two groups，while the differences in DCR and PFS were statistically significant. The main adverse reactions in both groups were rash， liver dysfunction， gastrointestinal ulcers， hypothyroidism， and oral ulcers. The adverse reactions in both groups were mild. Compared with the control group， 3 patients in the observation group had abdominal pain， which was relieved after drug reduction， and 8 patients had 1-2 levels of bone marrow depression， which recovered after colony-stimulating factor treatment. Conclusions Compared with PD1 inhibitor combined with furoquantinib， the combination of TAS102 on this basis can prolong the survival period of patients with advanced colorectal cancer and tolerate adverse reactions. This regimen has the potential to become a new strategy for the third line treatment of advanced colorectal cancer.

Key words： furoquantinib; PD1 inhibitor; TAS-102; colorectal cancer

Cite this article

Xiaoqin SU , Xi CHEN , Haihua FAN , Congfei JI , Tingting NI , Yang YU , Jia. CHEN . The clinical value of PD1 inhibitor combined with furoquantinib and TAS⁃102 posterior therapy for advanced colorectal cancer[J]. The Journal of Practical Medicine, 2023 , 39(18) : 2389 -2394 . DOI: 10.3969/j.issn.1006-5725.2023.18.018

References

1 SUNG H， FERLAY J， SIEGEL R L， et al. Global cancer statistics 2020：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］. CA A Cancer J Clin， 2021，71（3）：209-249.
2 张建锋，高相鑫，武雪亮，等. 结直肠癌NO.253淋巴结转移的危险因素分析［J］. 实用医学杂志，2021，37（22）：2893-2897.
3 DONG C X， DING Y W， WENG S S，et al. Update in version 2021 of CSCO guidelines for colorectal cancer from version 2020［J］. Chin J Cancer Res，2021，33（3）：302-307.
4 SUN LY， HUANG S L， LI D，et al. Efficacy and Safety of Fruquintinib Plus PD-1 Inhibitors Versus Regorafenib Plus PD-1 Inhibitors in Refractory Microsatellite Stable Metastatic ColorectalCancer［J］. Front Oncol， 2021，11： 754881.
5 肖鹏，李伟娟，梅家转，等. 阿帕替尼联合PD-1单抗后线治疗晚期结直肠癌患者的疗效和安全性［J］. 实用医学杂志，2023，39（2）：255-261.
6 JING Z， RUI Z， BINGLAN Z. A comparison of regorafenib and fruquintinib for metastatic colorectal cancer： a systematic review and network meta-analysis［J］. J Cancer Res Clin Oncol，2019， 145 （9）： 2313-2323.
7 LIU S， LU L， PAN F， et al. Real-world data：fruquintinib in treating metastatic colorectal cancer［J］. Oncol Res， 2022， 29（1）：25-31.
8 PENG Z， HOU X D， HUANG Y M， et al.Cost-effectiveness analysis of fruquintinib for metastatic colorectal cancer third-line treatment in China［J］. BMC Cancer， 2020，20： 990.
9 TORBEN F H， CAMiILLA Q， Pr Per，et al. Angiogenesis Inhibitors for Colorectal Cancer. A Review of the Clinical Data［J］. Cancers （Basel）， 2021， 13（5）： 1031.
10 OLIVEIRA A F， BRETES L， FURTADO I. Review of PD-1/PD-L1 inhibitors in metastatic dMMR/MSI-H colorectal cancer［J］. Front Oncol，2019，9：396.
11 CAO M， ZHOU M， ZHANG J.Comparison of efficacy and safety for patients with beyond second line treated metastatic colorectal cancer： a network meta-analysis of randomized controlled trials［J］. J Chemother， 2020， 32 （4）： 163-170.
12 FUKUOKA S H， TAKAHASHI N，et al. Regorafenib plus nivolumab in patients with advanced gastric or colorectal cancer： an open-label， dose-escalation， and dose-expansion phase Ib trial（REGONIVO，EPOC1603）［J］. J Clin Oncol. 2020，38（18）：2053-2061.
13 郑维维，钱程，邹伟，等. 免疫检查点抑制剂与抗血管生成药物合用治疗肿瘤的研究进展［J］. 中国药理学通报，2021，37（2）：175-179.
14 LU S， ZHOU J Y， NIU X M， et al. Fruquintinib with gefitinib as first-line therapy in patients carrying EGFR mutations with advanced non-small cell lung cancer： a single-arm， phase II study［J］. Transl Lung Cancer Res， 2021， 10 （2）： 839-854.
15 SHIRLEY M. Fruquintinib： First Global Approval［J］. Drugs， 2018， 78（16）： 1757-1761.
16 CHEN J， WANG J， LIN H， et al. Comparison of Regorafenib，Fruquintinib，and TAS-102 in Previously Treated Patients with Metastatic Colorectal Cancer： A Systematic Review and Network Meta-Analysis of Five Clinical Trials ［J］. Med Sci Monit，2019，25：9179-9191.
17 XU J， KIM T W， SHEN L， et al.Results of a randomized， double-blind，placebo-controlled， phase III trial of trifluridine/tipiracil （TAS-102） monotherapy in asian patients with previously treated metastatic colorectal cancer： The TERRA Study［J］. J Clin Oncol，2018，36（4）：350-358.
18 章俊，董宇华，杨叶，等. Regorafenib联合TAS102新策略治疗肝细胞癌的研究［J］. 中国癌症杂志，2021，31（4）：294-301.
19 SUZUKI N， NAKAGAWA F， MATSUOKA K， et al. Effect of anovel oral chemotherapeutic agent containing a combination of trifluridine， tipiracil and the novel triple angiokinase inhibitor nintedanib， on human colorectal cancer xenografts［J］. Oncol Rep， 2016， 36（6）： 3123-3130.
20 PFEIFFER P， YILMAZ M， M?LLER S， et al. TAS-102 with or without bevacizumab in patients with chemorefractory metastatic colorectal cancer： an investigator-initiated， open-label， randomised， phase 2 trial［J］. Lancet Oncol， 2020， 21（3）： 412-420.
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