Fruquintinib in metastatic colorectal cancer: a multicenter real-world analysis on efficacy, safety, and predictive and prognostic factors

Yi Wang ¹, Jianfen Xu ², Mingjun Dong ³

¹Department of Radiotherapy and Chemotherapy, Ningbo No. 2 Hospital, Ningbo, China.
²Department of Medical Oncology, Ningbo No. 2 Hospital, Ningbo, China.
³Department of Anus & Intestine Surgery, Ningbo No. 2 Hospital, Ningbo, China.
⁴Department of Radiation Oncology, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China.
⁵Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo, China.
⁶Department of Radio Chemotherapy, The Affiliated People's Hospital of Ningbo University, Ningbo, China.
⁷Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, China.
⁸Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China.
⁹Department of Anorectal Surgery, Ningbo No. 2 Hospital, Ningbo, China.
¹⁰Department of Colorectal Surgery, Ningbo No. 2 Hospital, Ningbo, China.
¹¹Hepatobiliary and Pancreatic Surgery Department, Ningbo No. 2 Hospital, Ningbo, China.
¹²Tumor HIFU Department, Ningbo No. 2 Hospital, Ningbo, China.

⁰Department of Radiotherapy and Chemotherapy, Ningbo No. 2 Hospital, Ningbo, China.

Journal of Gastrointestinal Oncology +

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September 16, 2024

View abstract on PubMed

Summary

This study shows fruquintinib offers survival benefits for metastatic colorectal cancer (mCRC) patients in real-world settings. Key predictors of survival include brain metastasis, decreased skeletal muscle index (SMI), and elevated carcinoembryonic antigen (CEA) levels.

Area Of Science

Oncology
Gastroenterology
Clinical Pharmacology

Background

Randomized trials indicate fruquintinib improves survival in metastatic colorectal cancer (mCRC) post-standard therapy.
Real-world prognostic analyses for fruquintinib in mCRC are limited.
This study assesses real-life survival, safety, and prognostic factors for fruquintinib-treated mCRC patients.

Purpose Of The Study

To evaluate the real-world effectiveness and safety of fruquintinib in advanced colorectal cancer (CRC).
To identify predictive and prognostic factors influencing outcomes in patients treated with fruquintinib.
To compare real-world findings with previous phase III clinical trial data.

Main Methods

A multi-center study collected data from 140 advanced CRC patients treated with fruquintinib.
Progression-free survival (PFS), overall survival (OS), and L3 skeletal muscle index (SMI) were primary endpoints.
Safety follow-up and multivariate analysis were conducted to identify prognostic factors.

Main Results

Median PFS and OS were 6.3 and 12.6 months, respectively, for all patients.
For patients with SMI analysis (n=76), median PFS and OS were 6.0 and 12.0 months.
Independent predictors of OS included brain metastasis (HR 2.78), >5% SMI decrease (HR 9.73), and baseline CEA level (HR 4.06).
Common adverse events included hypertension (17.1%), fatigue (15%), and hand-foot syndrome (14.3%).

Conclusions

Fruquintinib demonstrates real-world efficacy and safety numerically superior to phase III trials in advanced CRC.
Skeletal muscle index (SMI), brain metastasis, and carcinoembryonic antigen (CEA) levels are potential markers for patient selection.
These findings support fruquintinib's role in managing refractory advanced CRC.

Keywords:

Fruquintinib predictive factor prognostic factor real world skeletal muscle index (SMI)