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Prognostic scores for evaluating the survival benefit of regorafenib or trifluridine/tipiracil in patients with metastatic colorectal cancer: an exploratory analysis of the REGOTAS study.
International Journal of Clinical Oncology ( IF 3.3 ) Pub Date : 2019-12-14 , DOI: 10.1007/s10147-019-01600-0
Toshikazu Moriwaki 1 , Shota Fukuoka 2 , Toshiki Masuishi 3 , Atsuo Takashima 4 , Yosuke Kumekawa 5 , Takeshi Kajiwara 6 , Kentaro Yamazaki 7 , Taito Esaki 8 , Akitaka Makiyama 9 , Tadamichi Denda 10 , Yukimasa Hatachi 11 , Takeshi Suto 12 , Naotoshi Sugimoto 13 , Masanobu Enomoto 14 , Toshiaki Ishikawa 15 , Tomomi Kashiwada 16 , Eiji Oki 17 , Yoshito Komatsu 18 , Akihito Tsuji 19 , Kenji Tsuchihashi 20 , Daisuke Sakai 21 , Hideki Ueno 22 , Takao Tamura 23 , Kimihiro Yamashita 24 , Yasuhiro Shimada 25
Affiliation  

BACKGROUND Although regorafenib or trifluridine/tipiracil (FTD/TPI) has been recognized as a later-line standard treatment in patients with metastatic colorectal cancer (mCRC), not all patients have beneficial outcomes. This study aimed to develop a prognostic scoring system for evaluating the overall survival (OS) benefit. METHODS Patients included in the REGOTAS study, which comprised 489 patients (regorafenib group: 199; FTD/TPI group: 290 patients), were evaluated. OS was analyzed using multivariate Cox proportional model. The prognostic score was calculated using the worst four individual factors weighted by hazard ratio, and the total scores were categorized as low-, moderate-, and high-OS benefit. RESULTS The worst four factors in the regorafenib group were AST > 40 IU/dL (point, + 3), CRP ≥ 1.0 mg/dL (+ 2), number of metastatic organ site ≥ 3 (+ 2), and duration from initiation of 1st-line chemotherapy < 18 months (+ 2), while they were AST (+ 2), CRP (+ 2), CA19-9 > 37.0 U/mL (+ 2), and ECOG PS ≥ 1 (+ 2) in the FTD/TPI group. These corresponded to a total prognostic score of > 5, 2-4, and 0 points in the regorafenib group and 8, 2-6, and 0 points in the FTD/TPI group. The median OS in the low, moderate, and high OS benefit group was 3.3 (95% CI 3.0-3.7), 8.1 (95% CI 6.4-9.7), and 12.6 months (95% CI 10.6-14.6) in the regorafenib group and 2.8 (95% CI 2.0-3.5), 7.5 (95% CI 6.6-8.3), and 15.4 months (95% CI 9.7-21.2) in the FTD/TPI group. CONCLUSION These prognostic scores are useful for identifying patients with mCRC who will obtain survival benefits from these drugs.

中文翻译:

评估瑞格非尼或三氟吡啶/替比西酯在转移性结直肠癌患者中的生存获益的预后评分:REGOTAS研究的探索性分析。

背景技术尽管瑞戈非尼或三氟吡啶/替吡西酯(FTD / TPI)已被认为是转移性结直肠癌(mCRC)患者的晚期标准治疗方法,但并非所有患者均受益。这项研究旨在开发一种预后评分系统,以评估整体生存(OS)获益。方法对REGOTAS研究中包括489例患者(regorafenib组:199例; FTD / TPI组:290例)进行了评估。使用多元Cox比例模型分析OS。预后评分是根据危害比加权的最差的四个因素进行计算的,总评分分为低,中和高OS获益。结果regorafenib组中最差的四个因素是AST> 40 IU / dL(点,+ 3),CRP≥1.0 mg / dL(+ 2),转移器官部位的数量≥3(+ 2),开始一线化疗的持续时间<18个月(+ 2),而AST(+ 2),CRP(+ 2),CA19-9> 37.0 U / mL(+ 2),并且FTD / TPI组的ECOG PS≥1(+ 2)。这些对应于瑞戈非尼组的总预后评分> 5、2-4和0分,而FTD / TPI组的总预后评分为8、2-6和0分。雷戈非尼组中低,中和高OS受益组的中位OS为3.3(95%CI 3.0-3.7),8.1(95%CI 6.4-9.7)和12.6个月(95%CI 10.6-14.6) FTD / TPI组分别为2.8(95%CI 2.0-3.5),7.5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分对于确定将从这些药物中获得生存益处的mCRC患者有用。18个月(+ 2),而在FTD / TPI组中,它们分别是AST(+ 2),CRP(+ 2),CA19-9> 37.0 U / mL(+ 2)和ECOG PS≥1(+ 2)。 。这些对应于瑞戈非尼组的总预后评分> 5、2-4和0分,而FTD / TPI组的总预后评分为8、2-6和0分。雷戈非尼组中低,中和高OS受益组的中位OS为3.3(95%CI 3.0-3.7),8.1(95%CI 6.4-9.7)和12.6个月(95%CI 10.6-14.6) FTD / TPI组分别为2.8(95%CI 2.0-3.5),7.5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分对于确定将从这些药物中获得生存益处的mCRC患者有用。18个月(+ 2),而在FTD / TPI组中,它们分别是AST(+ 2),CRP(+ 2),CA19-9> 37.0 U / mL(+ 2)和ECOG PS≥1(+ 2)。 。这些对应于瑞戈非尼组的总预后评分> 5、2-4和0分,而FTD / TPI组的总预后评分为8、2-6和0分。雷戈非尼组中低,中和高OS受益组的中位OS为3.3(95%CI 3.0-3.7),8.1(95%CI 6.4-9.7)和12.6个月(95%CI 10.6-14.6) FTD / TPI组分别为2.8(95%CI 2.0-3.5),7.5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分有助于识别可从这些药物中获得生存益处的mCRC患者。这些对应于瑞戈非尼组的总预后评分> 5、2-4和0分,而FTD / TPI组则为8、2-6和0分。雷戈非尼组中低,中和高OS受益组的中位OS为3.3(95%CI 3.0-3.7),8.1(95%CI 6.4-9.7)和12.6个月(95%CI 10.6-14.6) FTD / TPI组分别为2.8(95%CI 2.0-3.5),7.5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分对于确定将从这些药物中获得生存益处的mCRC患者有用。这些对应于瑞戈非尼组的总预后评分> 5、2-4和0分,而FTD / TPI组的总预后评分为8、2-6和0分。雷戈非尼组中低,中和高OS受益组的中位OS为3.3(95%CI 3.0-3.7),8.1(95%CI 6.4-9.7)和12.6个月(95%CI 10.6-14.6) FTD / TPI组分别为2.8(95%CI 2.0-3.5),7.5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分有助于识别可从这些药物中获得生存益处的mCRC患者。FTD / TPI组为5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分对于确定将从这些药物中获得生存益处的mCRC患者有用。FTD / TPI组为5(95%CI 6.6-8.3)和15.4个月(95%CI 9.7-21.2)。结论这些预后评分有助于识别可从这些药物中获得生存益处的mCRC患者。
更新日期:2020-01-04
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