A leading oncologist from Washington University School of Medicine in St. Louis, Katrina S. Pedersen, MD, MS, recently discussed key updates and FDA approvals in 2023 for the treatment of patients with metastatic colorectal cancer (mCRC).
According to Pedersen, patients with mCRC typically undergo fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, followed by a VEGF inhibitor and an EGFR inhibitor as needed. Historically, patients with refractory mCRC who have tried 3 or more prior lines of therapy have faced unmet needs. However, two FDA approvals in 2023 have helped address these issues.
One of the approvals was for the combination of trifluridine-tipiracil and bevacizumab (Lonsurf and Avastin) based on the phase 3 SUNLIGHT trial (NCT04737187). This combination showed improved progression-free survival (PFS) and overall survival (OS) compared to trifluridine-tipiracil alone in patients with refractory mCRC. Pedersen has personally witnessed the clinical benefits of this combination in her practice.
Additionally, in November 2023, the FDA approved fruquintinib (Fruzaqla) for the treatment of adult patients with previously treated mCRC. Data from the phase 3 FRESCO-2 trial (NCT04322539) supported this decision, demonstrating that fruquintinib plus best supportive care (BSC) provided PFS and OS benefits compared to BSC alone.
These new treatment options, trifluridine-tipiracil plus bevacizumab and fruquintinib, offer a wider range of choices for mCRC patients beyond the previously approved therapies for specific biomarker-selected populations. Overall, these advancements are promising for improving outcomes and addressing the unmet needs of patients with mCRC, according to Pedersen.
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