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.contributor.authorŞenocak Taşçı, Elif
dc.contributor.authorOyan, Başak
dc.contributor.authorSönmez, Özlem
dc.contributor.authorMutlu, Arda Ulaş
dc.contributor.authorAtçı, Muhammed Mustafa
dc.contributor.authorSakin, Abdullah
dc.contributor.authorÖner, İrem
dc.contributor.authorYeşil Çınkır, Havva
dc.contributor.authorKarakurt Eryılmaz, Melek
dc.contributor.authorÇağlayan, Dilek
dc.contributor.authorBalçık, Onur Yazdan
dc.contributor.authorPaksoy, Nail
dc.contributor.authorBozkurt, Mustafa
dc.date.accessioned2024-01-15T11:56:52Z
dc.date.available2024-01-15T11:56:52Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
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.citationŞenocak Taşçı, E., Oyan, B., Sönmez, Ö., Mutlu, A. U., Atçı, M. M., Sakin, A. ... Bozkurt, M. (2024). Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer. BMC Cancer, 24(1). https://dx.doi.org/10.1186/s12885-023-11783-5
dc.identifier.doi10.1186/s12885-023-11783-5
dc.identifier.issn1471-2407
dc.identifier.issue1
dc.identifier.pmid38166764
dc.identifier.scopus2-s2.0-85181247540
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://dx.doi.org/10.1186/s12885-023-11783-5
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12141
dc.identifier.volume24
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorSakin, Abdullah
dc.language.isoen
dc.publisherBioMed Central Ltd
dc.relation.ispartofBMC Canceren_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
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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