title: Efficacy and Safety of TAS-102 in Clinical Practice of Salvage Chemotherapy for Metastatic Colorectal Cancer.
abstract: BACKGROUND
  TAS-102 is an anti-metabolite which demonstrated activity against multidrug-resistant advanced colorectal cancer. Its major toxicities are hematological disorders.
  
  
  METHODS
  Background, TAS-102 efficacy, toxicities and outcomes for patients with multidrug-resistant advanced colorectal cancer from six Institutions of the Kyushu Medical Oncology Group were retrospectively surveyed.
  
  
  RESULTS
  Forty-three patients, including fragile patients due to declining performance status and other comorbidities (37%) were analyzed. Efficacy was reflected in an objective overall response of 3%, median progression-free survival of 74 days (2.5 months) and median overall survival of 229 days (7.6 months). The most frequent Common Terminology Criteria for Adverse Events grade 3/4 adverse events were neutropenia (44%), leukopenia (26%) and anemia (23%). Febrile neutropenia was found in 7%. Sub-group analysis demonstrated an improved outcome on treatment with the sequence regorafenib-TAS-102.
  
  
  CONCLUSIONS
  TAS-102 was safely administered to modestly fragile patients with equivalent efficacy to that for the non-fragile population. Further investigation of sequential treatment using regorafenib and TAS-102 is needed.
authors.affiliation: Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Arita
authors.affiliation: Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shirakawa
authors.affiliation: Department of Medical Oncology, Hamanomachi Hospital, Fukuoka, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Matsushita
authors.affiliation: Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Hozumi Kumagai
authors.initials: HK
authors.lastname: Shimokawa
authors.affiliation: Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Hirano
authors.affiliation: Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan.
authors.forename: Akitaka
authors.initials: A
authors.lastname: Makiyama
authors.affiliation: Department of Chemotherapy, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Tamura
authors.affiliation: Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Taito
authors.initials: T
authors.lastname: Esaki
authors.affiliation: Department of Medical Oncology, Hamanomachi Hospital, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Mitsugi
authors.affiliation: Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ariyama
authors.affiliation: Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kusaba
authors.affiliation: Department of Hematology and Medical Oncology, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
authors.affiliation: Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan e-baba@c-oncology.med.kyushu-u.ac.jp.
authors.forename: Eishi
authors.initials: E
authors.lastname: Baba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004338:Drug Combinations; D018432:Drug Resistance, Multiple; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use*; D011759:Pyrrolidines; D016879:Salvage Therapy; D016019:Survival Analysis; D013941:Thymine; D016896:Treatment Outcome; D014271:Trifluridine / Q000009:adverse effects / Q000627:therapeutic use*; D014498:Uracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D004338:Drug Combinations; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D011759:Pyrrolidines; C000613803:trifluridine tipiracil drug combination; C559147:regorafenib; D014498:Uracil; D013941:Thymine; D014271:Trifluridine
keywords: TAS-102; TFTD; colorectal cancer; regorafenib; salvage chemotherapy