Efficacy comparison of fruquintinib,regorafenib monotherapy or plus programmed death-1 inhibitors for microsatellite stable metastatic colorectal cancer  

作　　者：Tian-Qi An Hui Qiu Quan-Bo Zhou Hong Zong Shuang Hu Yu-Gui Lian Rui-Hua Zhao 

机构地区：[1]Department of Oncology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China [2]Department of Hepato-Pancreato-Biliary Surgery,Peking University Cancer Hospital and Institute,Beijing 100000,China [3]Department of Colorectal Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第6期2449-2462,共14页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND Regorafenib(R)and fruquintinib(F)are the standard third-line regimens for colorectal cancer(CRC)according to the National Comprehensive Cancer Network guidelines,but both have limited efficacy.Several phase 2 trials have indicated that R or F combined with immune checkpoint inhibitors can reverse immunosuppression and achieve promising efficacy for microsatellite stable or proficient mismatch repair(MSS/pMMR)CRC.Due to the lack of studies comparing the efficacy between F,R,F plus programmed death-1(PD-1)inhibitor,and R plus PD-1 inhibitors(RP),it is still unclear whether the combination therapy is more effective than monotherapy.AIM To provide critical evidence for selecting the appropriate drugs for MSS/pMMR metastatic CRC(mCRC)patients in clinical practice.METHODS A total of 2639 CRC patients were enrolled from January 2018 to September 2022 in our hospital,and 313 MSS/pMMR mCRC patients were finally included.RESULTS A total of 313 eligible patients were divided into F(n=70),R(n=67),F plus PD-1 inhibitor(FP)(n=95)and RP(n=81)groups.The key clinical characteristics were well balanced among the groups.The median progression-free survival(PFS)of the F,R,FP,and RP groups was 3.5 months,3.6 months,4.9 months,and 3.0 months,respectively.The median overall survival(OS)was 14.6 months,15.7 months,16.7 months,and 14.1 months.The FP regimen had an improved disease control rate(DCR)(P=0.044)and 6-month PFS(P=0.014)and exhibited a better trend in PFS(P=0.057)compared with F,and it was also significantly better in PFS than RP(P=0.030).RP did not confer a significant survival benefit;instead,the R group had a trend toward greater benefit with OS(P=0.080)compared with RP.No significant differences were observed between the R and F groups in PFS or OS(P>0.05).CONCLUSION FP is superior to F in achieving 6-month PFS and DCR,while RP is not better than R.FP has an improved PFS and 6-month PFS compared with RP,but F and R had similar clinical efficacy.Therefore,FP may be a highly promising strategy in the treatment of M

关 键 词：Colorectal cancer Fruquintinib REGORAFENIB Programmed death-1 inhibitor Real-world 

分 类 号：R735.34[医药卫生—肿瘤]