Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer

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dc.authoridMutlu, Arda Ulas/0000-0001-7499-7155
dc.contributor.authorTasci, Elif Senocak
dc.contributor.authorOyan, Basak
dc.contributor.authorSoenmez, Oezlem
dc.contributor.authorMutlu, Arda Ulas
dc.contributor.authorAtci, Muhammed Mustafa
dc.contributor.authorSakin, Abdullah
dc.contributor.authorOener, Irem
dc.date.accessioned2024-10-29T17:58:49Z
dc.date.available2024-10-29T17:58:49Z
dc.date.issued2024
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractBackground The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib has been the standard of care in this setting as it improved overall survival (OS) compared to placebo. In real-world practice chemotherapy rechallenge is also a preferred option even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC.Methods In this retrospective multi-institutional trial, mCRC patients from 21 oncology centers who progressed after 2 lines of chemotherapy were analyzed. Patients who were treated with regorafenib or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. OS, disease control rate (DCR), progression free survival (PFS) and toxicity were analyzed.Results Three hundred ninety-four mCRC patients were included in the study. 128 (32.5%) were in the rechallenge, and 266 (67.5%) were in the regorafenib group. Median PFS was 5.82 months in rechallenge and 4 months in regorafenib arms (hazard ratio:1.45,95% CI, p = 0.167). DCR was higher in the rechallenge group than regorafenib (77% vs 49.5%, respectively, p = < 0.001). Median OS after the third-line treatment was 11.99 (95% CI, 9.49-14.49) and 8.08 months (95% CI, 6.88-9.29) for rechallenge and regorafenib groups, respectively (hazard ratio:1.51, 95% CI, p < 0.001). More adverse effects and discontinuation were seen with regorafenib treatment.Conclusion Our study revealed that higher disease control and OS rates were achieved with rechallenge treatment compared to regorafenib, especially in patients who achieved disease control in one of the first two lines of therapy.
dc.identifier.doi10.1186/s12885-023-11783-5
dc.identifier.issn1471-2407
dc.identifier.issue1en_US
dc.identifier.pmid38166764
dc.identifier.scopus2-s2.0-85181247540
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1186/s12885-023-11783-5
dc.identifier.urihttps://hdl.handle.net/20.500.11776/14517
dc.identifier.volume24
dc.identifier.wosWOS:001135401800028
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBmc
dc.relation.ispartofBmc Cancer
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectColon cancer
dc.subjectFluouracil
dc.subjectRechallenge
dc.subjectRegorafenib
dc.subjectSurvival
dc.subjectThird-line treatment
dc.titleComparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer
dc.typeArticle

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