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Comparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer

dc.contributor.coauthorTasci, Elif Senocak
dc.contributor.coauthorOyan, Basak
dc.contributor.coauthorSönmez, Oezlem
dc.contributor.coauthorMutlu, Arda Ulas
dc.contributor.coauthorAtci, Muhammed Mustafa
dc.contributor.coauthorSakin, Abdullah
dc.contributor.coauthorOener, Irem
dc.contributor.coauthorCinkir, Havva Yesil
dc.contributor.coauthorEryilmaz, Melek Karakurt
dc.contributor.coauthorCaglayan, Dilek
dc.contributor.coauthorBalcik, Onur Yazdan
dc.contributor.coauthorPaksoy, Nail
dc.contributor.coauthorKarabulut, Senem
dc.contributor.coauthorSalim, Derya Kivrak
dc.contributor.coauthorBilir, Cemil
dc.contributor.coauthorOezen, Mirac
dc.contributor.coauthorOezcelik, Melike
dc.contributor.coauthorArican, Ali
dc.contributor.coauthorAkaguenduez, Baran
dc.contributor.coauthorInal, Ali
dc.contributor.coauthorAydin, Dincer
dc.contributor.coauthorOezer, Leyla
dc.contributor.coauthorGuelmez, Ahmet
dc.contributor.coauthorTurhal, Nazim Serdar
dc.contributor.coauthorEsen, Selin Aktuerk
dc.contributor.coauthorAlgin, Efnan
dc.contributor.coauthorIriagac, Yakup
dc.contributor.coauthorSakalar, Teoman
dc.contributor.coauthorUenal, Caglar
dc.contributor.coauthorEr, Oezlem
dc.contributor.coauthorSecmeler, Saban
dc.contributor.coauthorBozkurt, Mustafa
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.kuauthorAkbaş, Sinem
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.date.accessioned2024-12-29T09:36:39Z
dc.date.issued2024
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.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue1
dc.description.openaccessgold
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume24
dc.identifier.doi10.1186/s12885-023-11783-5
dc.identifier.eissn1471-2407
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85181247540
dc.identifier.urihttps://doi.org/10.1186/s12885-023-11783-5
dc.identifier.urihttps://hdl.handle.net/20.500.14288/22113
dc.identifier.wos1135401800028
dc.keywordsColon cancer
dc.keywordsFluouracil
dc.keywordsRechallenge
dc.keywordsRegorafenib
dc.keywordsSurvival
dc.keywordsThird-line treatment
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofBMC Cancer
dc.subjectOncology
dc.titleComparing the efficacy of regorafenib and 5-fluorouracil-based rechallenge chemotherapy in the third-line treatment of metastatic colorectal cancer
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorAkbaş, Sinem
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
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relation.isParentOrgUnitOfPublication055775c9-9efe-43ec-814f-f6d771fa6dee
relation.isParentOrgUnitOfPublication.latestForDiscovery055775c9-9efe-43ec-814f-f6d771fa6dee

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