Metastatic CRC: bevacizumab boosts TAS-102

  • Lancet Oncol

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • The addition of bevacizumab to TAS-102 leads to improved survival in metastatic colorectal cancer (CRC), with little effect on adverse events other than neutropenia.

Why this matters

  • The authors suggest that the finding should change practice, but an accompanying editorial calls for more data before guidelines should be changed.

Study design

  • Open-label, randomized, phase 2 trial at 4 centers in Denmark (n=93).
  • Patients were randomly assigned to oral TAS-102 alone or TAS-102 combined with bevacizumab.
  • Included patients had metastatic CRC refractory or intolerant to a fluoropyrimidine, irinotecan, oxaliplatin, and cetuximab or panitumumab (RAS wild-type only).
  • Funding: Servier.

Key results

  • Median follow-up, 10.0 months.
  • Median PFS was longer in the TAS-102/bevacizumab group:
    • 4.6 vs 2.6 months;
    • HR, 0.45 (P=.0015).
  • Median OS was longer in the TAS-102/bevacizumab group:
    • 9.4 vs 6.7 months;
    • HR, 0.55 (P=.028).
  • Grade 3 or higher adverse events included neutropenia (38% in TAS-102 vs 67% in the TAS-102/bevacizumab group).
  • Severe adverse events occurred in 45% of the TAS-102 group and 41% of the TAS-102/bevacizumab group.

Limitations

  • Open-label design.
  • Small sample size.