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REVIEW article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1502185
This article is part of the Research Topic Adapting Drug Repurposing to Drug Resistance in Cancer Volume II: Developing Synergistic Combinations View all 3 articles

Trifluridine/tipiracil regimen in combination with bevacizumab for metastatic colorectal cancer in the third line -An Expert Opinion

Provisionally accepted
Carmine Pinto Carmine Pinto 1*Sara Lonardi Sara Lonardi 2Evaristo Maiello Evaristo Maiello 3Erika Martinelli Erika Martinelli 4Michele Prisciandaro Michele Prisciandaro 5Lisa Salvatore Lisa Salvatore 6Andrea Sartore-Bianchi Andrea Sartore-Bianchi 7Mario Scartozzi Mario Scartozzi 8Giuseppe Aprile Giuseppe Aprile 9Chiara Cremolini Chiara Cremolini 10Alberto Sobrero Alberto Sobrero 11
  • 1 IRCCS Local Health Authority of Reggio Emilia, Reggio Emilia, Italy
  • 2 Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
  • 3 Oncology Unit, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy, San Giovanni Rotondo (FG), Italy
  • 4 Oncologia Medica, Dipartimento di Medicina di Precisione, Università degli Studi della Campania “L. Vanvitelli “, Napoli, Italy
  • 5 Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
  • 6 Medical Oncology, Università Cattolica del Sacro Cuore, Rome, Italy
  • 7 Division of Clinical Research and Innovation, ASST Grande Ospedale Metropolitano Niguarda, University of Milano, Milano, Italy
  • 8 Oncologia Medica, Azienda Ospedaliero Universitaria e Università degli Studi di Cagliari, Cagliari, Italy
  • 9 Department of Medical Oncology, AULSS8 Berica, Vicenza, Italy
  • 10 Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Tuscany, Italy
  • 11 Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy

The final, formatted version of the article will be published soon.

    The prolongation of survival along with the preservation of quality of life, possibly avoiding harmful cumulative toxicities are the primary therapeutic aims for patients with metastatic colorectal cancer (mCRC) in third line setting. Several therapeutic options are now available, although some differences across Countries in drug approval and the optimal therapeutic sequencing associated to each peculiar patients subgroup represent a clinical challenge for oncologists. Among various options, the SUNLIGHT trial showed how the combination of trifluridine/tipiracil (FTD/TPI) with bevacizumab is effective with an easily manageable toxicity profile compared to FTD/TPI alone. Of note, the efficacy is confirmed independently from KRAS mutational status and also for patients who had breaks in anti-VEGF therapy. Herein, we describe the current state of the art in the landscape of treatments after second progression in mCRC. Based on a critical review of the literature aimed to guide clinicians in their daily decision-making, we point out that the combination of FTD/TPI with bevacizumab produces a clinical benefit in unselected mCRC patients. Therefore, FTD/TPI plus bevacizumab regimen can represent a new standard of care for the treatment of patients with refractory mCRC who have progressed after two lines of therapy.

    Keywords: Trifluridine/tipiracil, bevacizumab, Third line therapy, Metastatic colorectal cancer, efficacy, Safety

    Received: 26 Sep 2024; Accepted: 31 Oct 2024.

    Copyright: © 2024 Pinto, Lonardi, Maiello, Martinelli, Prisciandaro, Salvatore, Sartore-Bianchi, Scartozzi, Aprile, Cremolini and Sobrero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Carmine Pinto, IRCCS Local Health Authority of Reggio Emilia, Reggio Emilia, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.