Analysis of neutropenia as a predictive factor of the efficacy of trifluridine-tipiracil treatment.

IF 0.9 4区 医学 Q4 PHARMACOLOGY & PHARMACY International journal of clinical pharmacology and therapeutics Pub Date : 2023-08-01 DOI:10.5414/CP204410
Loreto Domínguez Senín, María Yeray Rodriguez Garcés, Victoria Aviñó Tarazona, María Amor Urbano, Maria Dolores Santos-Rubio, Juan Bayo Calero
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Abstract

Objectives: Trifluridine-tipiracil (TAS-102), an oral cytotoxic agent used in adult patients with refractory metastatic colorectal cancer (mCRC), has been associated with neutropenia (chemotherapy-induced neutropenia) (CIN)).

Materials and methods: We evaluated the efficacy and safety of TAS-102 in a group of 45 mCRC patients (median age 66 years) in Huelva province, Spain, in a retrospective, multicenter observational study.

Results: We showed that the association between TAS-102 and CIN can be used as a predictor of efficacy. 20% (9/45) of patients with an Eastern Cooperative Oncology Group (ECOG) score of 2 had received at least one previous chemotherapy treatment. Overall, 75.5% (34/45) and 28.9% (13/45) had received anti-VEGF and anti-EGFR monoclonal antibodies, respectively. Additionally, 80% (36/45) of patients had received third-line treatment. The mean treatment period, duration of overall survival (OS), and duration of progression-free survival (PFS) were 3.4, 12, and 4 months, respectively. A partial response was seen in 2 patients (4.3%), and disease stabilization was observed in 10 patients (21.3%). Neutropenia was the most frequent grade 3 - 4 toxicity (46.7%; 21/45). Other findings were anemia (77.8%; 35/45), all grades of neutropenia (73.3%; 33/45), and gastrointestinal toxicity (53.3%; 24/45). The dose of TAS-102 needed to be reduced in 68.9% (31/45) of patients, whereas treatment needed to be interrupted in 80% (36/45) of patients. Grade 3 - 4 neutropenia was a positive prognostic factor for OS (p = 0.023).

Conclusion: A retrospective evaluation shows that grade 3 - 4 neutropenia is an independent predictor of treatment response and survival in patients undergoing routine treatment for mCRC, but this finding needs confirmation in a prospective study.

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作为三氟吡啶-替吡拉西治疗疗效预测因素的中性粒细胞减少症分析。
目的:三氟啶-异曲西(TAS-102)是一种口服细胞毒性药物,用于难治性转移性癌症(mCRC)成年患者,与中性粒细胞减少症(化疗诱导的中性粒细胞减症)(CIN)有关。材料和方法:我们在西班牙韦尔瓦省的45名mCRC患者(中位年龄66岁)中评估了TAS-102的疗效和安全性,多中心观察性研究。结果:我们发现TAS-102和CIN之间的相关性可以作为疗效的预测指标。20%(9/45)的东部肿瘤协作组(ECOG)评分为2的患者至少接受过一次化疗。总体而言,分别有75.5%(34/45)和28.9%(13/45)接受了抗VEGF和抗EGFR单克隆抗体治疗。此外,80%(36/45)的患者接受了三线治疗。平均治疗期、总生存期(OS)和无进展生存期(PFS)分别为3.4、12和4个月。2名患者(4.3%)出现部分反应,10名患者(21.3%)病情稳定。中性粒细胞减少症是最常见的3-4级毒性(46.7%;21/45)。其他发现为贫血(77.8%;35/45)、所有级别的中性粒细胞减少症(73.3%;33/45)和胃肠道毒性(53.3%;24/45)。68.9%(31/45)的患者需要减少TAS-102的剂量,而80%(36/45)的患者则需要中断治疗。3-4级中性粒细胞减少症是OS的一个积极预后因素(p=0.023)。结论:一项回顾性评估显示,在接受mCRC常规治疗的患者中,3-4级中性白细胞减少症可以独立预测治疗反应和生存率,但这一发现需要在前瞻性研究中得到证实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
12.50%
发文量
116
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacology and Therapeutics appears monthly and publishes manuscripts containing original material with emphasis on the following topics: Clinical trials, Pharmacoepidemiology - Pharmacovigilance, Pharmacodynamics, Drug disposition and Pharmacokinetics, Quality assurance, Pharmacogenetics, Biotechnological drugs such as cytokines and recombinant antibiotics. Case reports on adverse reactions are also of interest.
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