Biweekly Administration of TAS-102 for Neutropenia Prevention in Patients with Colorectal Cancer.
BACKGROUND/AIM
TAS-102 has led to a significant improvement in overall survival (OS) and progression-free survival (PFS) of patients with metastatic colorectal cancer (mCRC). Neutropenia is the most common adverse event and an important factor impacting chemotherapy continuation. In this retrospective study, factors associated with grade ≥3 neutropenia, that is frequently observed in TAS-102-treated patients, were examined.


PATIENTS AND METHODS
The medical records of 41 patients with CRC who received TAS-102 between October 2014 and June 2017 at the Fukuoka University Hospital were retrospectively reviewed. Response rate, PFS, OS, and adverse events were analyzed using KRAS mutation, administration method, concomitant drug administration, neutrophil-to-lymphocyte ratio (NLR), and Onodera's prognostic nutritional index (Onodera's index) as a stratification factors.


RESULTS
Both PFS and OS were significantly higher with TAS-102 plus bevacizumab combination therapy. Biweekly administration (7.1%) was associated with significantly less neutropenia compared to normal administration (44.4%). DCR with biweekly administration was better than that with normal administration, although without statistical significance. No significant difference was observed in OS rates between the biweekly and normal administration regimens; however, the biweekly regimen was associated with significantly prolonged PFS. By multivariate analysis, a significant difference was noted in the Onodera's index for OS and in the administration method and NLR for PFS.


CONCLUSION
Biweekly administration without a change in the drug dose intensity was associated with reduced neutropenia in patients with mCRC. The effects and adverse events of TAS-102 were associated with concomitant drug administration, administration method, and nutritional status.
['Yoshida|Yoichiro|Y|', 'Sakamoto|Ryohei|R|', 'Kajitani|Ryuji|R|', 'Munechika|Taro|T|', 'Matsumoto|Yoshiko|Y|', 'Komono|Akira|A|', 'Aisu|Naoya|N|', 'Daibo|Kojima|K|', 'Kiyomi|Fumihiko|F|', 'Hasegawa|Suguru|S|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000970:Antineoplastic Agents D015179:Colorectal Neoplasms D018572:Disease-Free Survival D004338:Drug Combinations D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009503:Neutropenia D011759:Pyrrolidines D012189:Retrospective Studies D013941:Thymine D014271:Trifluridine D014498:Uracil
TAS-102 neutropenia Colorectal cancer chemotherapy bevacizumab