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The fluoropyrimidine TAS-102 significantly extended overall survival (OS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC) refractory to 5-fluorouracil (5-FU), irinotecan, and oxaliplatin, according to findings from the phase III RECOURSE study.
Treatment TAS-102 reduced the risk of progression by 52% and extended survival by 32% when compared with placebo. The median OS was 7.1 months with TAS-102 compared with 5.3 months with placebo. The median PFS in the TAS-102 arm was 2 months versus 1.7 months with placebo.
The efficacy of TAS-102 indicates that the fluoropyrimidine pathway is still active in patients with refractory disease, notes Alan P. Venook, MD. Given its promise in the refractory setting, clinical trials should explore TAS-102 in combination with antiangiogenic therapies, suggests Al B. Benson III, MD.
Having another treatment for patients with refractory disease is helpful; however, fitting it in with current options represents the next challenge, notes Venook. An application for regulatory approval is expected for TAS-102 by the end of 2014. However, the overall efficacy of this drug suggests that fluoropyrimidines remain important across the entire treatment continuum for patients with mCRC.