Regorafenib with or without chemotherapy/immunotherapy in second-line treatment of metastatic colorectal cancer during the COVID-19 pandemic: a single-center retrospective analysis.

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Journal of gastrointestinal oncology Pub Date : 2024-12-31 Epub Date: 2024-12-28 DOI:10.21037/jgo-2024-891
Yu Xiao, Zhentao Liu, Francesco Mannavola, Baoshan Cao
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引用次数: 0

Abstract

Background: Regorafenib, approved in China for the third-line treatment of patients with metastatic colorectal cancer (mCRC), targets multiple tyrosine kinases. We retrospectively evaluated the efficacy and safety of regorafenib, both as monotherapy and in combination with capecitabine or immune checkpoint inhibitors (ICIs), as a second-line treatment for patients unable to access hospital-based care due to limited hospital visits during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Retrospective analysis was conducted on individual patient data from Peking University Third Hospital, covering the period from January 2020 to September 2023. The primary endpoint was progression-free survival (PFS), with secondary endpoints including overall survival (OS) and safety.

Results: The study comprised 31 patients with a median age of 65 years. The median PFS (mPFS) was 6.0 months, while the median OS (mOS) was 20.0 months. Compared to those treated with regorafenib alone, patients treated with regorafenib plus capecitabine/ICIs tended to have a longer PFS (8.0 vs. 4.0 months) and OS (27.0 vs. 15.0 months). Liver metastases [hazard ratio (HR) =2.515, 95% confidence interval (CI): 1.037-6.100; P=0.04] and prior bevacizumab treatment (HR =2.613, 95% CI: 1.168-5.846; P=0.02) were identified as independent prognostic factors for PFS. Frequent grade 3/4 adverse drug reactions (ADRs) included hand-foot skin reactions (HFSRs), fatigue, hypertension, and proteinuria.

Conclusions: This single-center, retrospective study indicates that regorafenib, alone or combined with chemotherapy/immunotherapy, is a feasible and safe second-line treatment for mCRC for situations where hospital access is limited, such as during the COVID-19 pandemic. Additional prospective studies are required to investigate the advantages of combination therapies.

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瑞非尼加或不加化疗/免疫治疗在COVID-19大流行期间转移性结直肠癌的二线治疗:单中心回顾性分析
背景:Regorafenib已获批用于转移性结直肠癌(mCRC)三线治疗,靶向多种酪氨酸激酶。我们回顾性评估了regorafenib作为单药治疗和与卡培他滨或免疫检查点抑制剂(ICIs)联合治疗的有效性和安全性,作为二线治疗,用于2019年冠状病毒病(COVID-19)大流行期间由于医院就诊次数有限而无法获得医院护理的患者。方法:对北京大学第三医院2020年1月至2023年9月的患者资料进行回顾性分析。主要终点是无进展生存期(PFS),次要终点包括总生存期(OS)和安全性。结果:该研究包括31例患者,中位年龄为65岁。中位PFS (mPFS)为6.0个月,中位OS (mOS)为20.0个月。与单用瑞非尼治疗的患者相比,瑞非尼联合卡培他滨/ICIs治疗的患者往往有更长的PFS(8.0个月vs. 4.0个月)和OS(27.0个月vs. 15.0个月)。肝转移[危险比(HR) =2.515, 95%可信区间(CI): 1.037 ~ 6.100;P=0.04]和既往贝伐单抗治疗(HR =2.613, 95% CI: 1.168-5.846;P=0.02)被认为是PFS的独立预后因素。常见的3/4级药物不良反应(adr)包括手足皮肤反应(HFSRs)、疲劳、高血压和蛋白尿。结论:这项单中心回顾性研究表明,在医院准入受限的情况下,如COVID-19大流行期间,瑞非尼单独或联合化疗/免疫治疗是一种可行且安全的mCRC二线治疗方法。需要更多的前瞻性研究来调查联合治疗的优势。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
171
期刊介绍: ournal of Gastrointestinal Oncology (Print ISSN 2078-6891; Online ISSN 2219-679X; J Gastrointest Oncol; JGO), the official journal of Society for Gastrointestinal Oncology (SGO), is an open-access, international peer-reviewed journal. It is published quarterly (Sep. 2010- Dec. 2013), bimonthly (Feb. 2014 -) and openly distributed worldwide. JGO publishes manuscripts that focus on updated and practical information about diagnosis, prevention and clinical investigations of gastrointestinal cancer treatment. Specific areas of interest include, but not limited to, multimodality therapy, markers, imaging and tumor biology.
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