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Abstract
The survival of patients with metastatic colorectal cancer has notably increased in the past 20 years, from 12 months to around 30 months. Nevertheless, the prognosis of patients pretreated with all available agents is poor and there is high unmet need for newer treatments. TAS-102 is an orally administered combination of the nucleoside analogue trifluridine and tipiracil hydrochloride, a thymidine phosphorylase inhibitor. In a randomized trial of 800 patients who had received at least two other treatments previously (most patients had received more than four treatments). TAS-102 demonstrated a significant prolongation of overall survival compared with placebo (median survival 7.1 vs. 5.3 months; hazard ratio 0 · 68, 95%CI: 0 · 58–0 · 81; p < 0 · 001). The toxicity was manageable, grade 3 or higher events occurred in 69% of patients in the TAS-102 group versus 52% in the placebo group, with neutropenia the most common event.
Financial & competing interests disclosure
G Masi has received honoraria and expenses for travel, accommodations, and meetings from Amgen, Merck, Bayer and Roche. C Cremolini has served on the advisory board for Roche and Bayer and received payment for the development of educational presentations from Bayer. F Loupakis served on the advisory board for Amgen, and Sanofi-Aventis, receiving payment for the development of educational presentations from Roche, Amgen and receiving lecture fees from Sanofi-Aventis, Bayer, Roche and receiving grant support from Roche and Merck Serono. A Falcone served on the advisory board for Amgen, Bayer, Merck Serono, Roche and Sanofi-Aventis, and has received payment for the development of educational presentations from Amgen, Bayer, Merck Serono, Roche and Sanofi-Aventis and has received lecture fees from Amgen, Bayer, Merck Serono, Roche and Sanofi-Aventis and has received grant support from Amgen, Merck Serono and Roche. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.