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Randomized trial of TAS-102 for refractory metastatic colorectal cancer

Abstract : BACKGROUND: Early clinical trials conducted primarily in Japan have shown that TAS-102, an oral agent that combines trifluridine and tipiracil hydrochloride, was effective in the treatment of refractory colorectal cancer. We conducted a phase 3 trial to further assess the efficacy and safety of TAS-102 in a global population of such patients. METHODS: In this double-blind study, we randomly assigned 800 patients, in a 2:1 ratio, to receive TAS-102 or placebo. The primary end point was overall survival. RESULTS: The median overall survival improved from 5.3 months with placebo to 7.1 months with TAS-102, and the hazard ratio for death in the TAS-102 group versus the placebo group was 0.68 (95% confidence interval [CI], 0.58 to 0.81; P\textless0.001). The most frequently observed clinically significant adverse events associated with TAS-102 were neutropenia, which occurred in 38% of those treated, and leukopenia, which occurred in 21%; 4% of the patients who received TAS-102 had febrile neutropenia, and one death related to TAS-102 was reported. The median time to worsening performance status (a change in Eastern Cooperative Oncology Group performance status [on a scale of 0 to 5, with 0 indicating no symptoms and higher numbers indicating increasing degrees of disability] from 0 or 1 to 2 or more) was 5.7 months with TAS-102 versus 4.0 months with placebo (hazard ratio, 0.66; 95% CI, 0.56 to 0.78; P\textless0.001). CONCLUSIONS: In patients with refractory colorectal cancer, TAS-102, as compared with placebo, was associated with a significant improvement in overall survival. (Funded by Taiho Oncology-Taiho Pharmaceutical; RECOURSE ClinicalTrials.gov number, NCT01607957.).
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01152847
Contributor : Laurent Jonchère <>
Submitted on : Monday, May 18, 2015 - 4:25:54 PM
Last modification on : Monday, December 16, 2019 - 6:38:12 PM

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Robert J. Mayer, Eric van Cutsem, Alfredo Falcone, Takayuki Yoshino, Rocio Garcia-Carbonero, et al.. Randomized trial of TAS-102 for refractory metastatic colorectal cancer. New England Journal of Medicine, Massachusetts Medical Society, 2015, 372 (20), pp.1909--1919. ⟨10.1056/NEJMoa1414325⟩. ⟨hal-01152847⟩

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