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Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable

Zhenzhen Gao1,2, Chenxi Cao3,2, Yi Bao1

  • 1Department of General surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China.

Technology in Cancer Research & Treatment
|September 11, 2020
PubMed
Abstract

Insights

This network meta-analysis compared regorafenib, trifluridine/tipiracil, and fruquintinib for metastatic colorectal cancer. Trifluridine/tipiracil and fruquintinib showed similar efficacy, outperforming regorafenib.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Intractable metastatic colorectal cancer (mCRC) presents limited treatment options.
  • Regorafenib, trifluridine/tipiracil, and fruquintinib are key therapeutic agents for refractory mCRC.

Purpose of the Study:

  • To conduct a network meta-analysis comparing the efficacy of regorafenib, trifluridine/tipiracil, and fruquintinib.
  • To evaluate overall survival (OS) and progression-free survival (PFS) in patients with mCRC who failed prior treatments.

Main Methods:

  • Systematic literature search of PubMed, EMBASE, Cochrane, and ClinicalTrials databases up to February 2020.
  • Inclusion of randomized controlled trials (RCTs) for regorafenib, trifluridine/tipiracil, or fruquintinib in pre-treated mCRC patients.
  • Network meta-analysis of OS and PFS using Review Manager and ADDIS software for direct and indirect comparisons.

Main Results:

  • Seven trials were analyzed, demonstrating trifluridine/tipiracil and regorafenib superiority over placebo for OS and PFS.
  • Regorafenib (80 mg) showed improved OS and PFS versus placebo but was inferior to trifluridine/tipiracil and fruquintinib.
  • Network analysis indicated similar efficacy between trifluridine/tipiracil and fruquintinib, both superior to regorafenib.

Conclusions:

  • Trifluridine/tipiracil and fruquintinib exhibit comparable efficacy in treating metastatic colorectal cancer.
  • While therapeutically similar, trifluridine/tipiracil and fruquintinib possess distinct toxicity profiles.
  • Regorafenib (80 mg) is less effective than trifluridine/tipiracil and fruquintinib in this patient population.
Keywords:
TAS-102colorectal cancerfruquintinibmeta-analysisregorafenib

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