Redefining Later-Line Therapy in Metastatic Colorectal Cancer

This symposium took place on 29th June 2017 as part of the 19th World Congress on Gastrointestinal Cancer in Barcelona, Spain

Chairpersons: Andres Cervantes,1 Dirk Arnold2
Speakers: Marc Peeters,3 Julien Taieb4

1. CIBERONC. Department of Medical Oncology, Biomedical Research Institute, Incliva, University of Valencia, Valencia, Spain
2. Instituto CUF de Oncologia (I.C.O.), Lisbon, Portugal
3. Antwerp University Hospital and Antwerp University, Antwerp, Belgium
4. GI Oncology Department, Georges Pompidou European Hospital, and Sorbonne Paris Cité, Paris-Descartes University, Paris, France

Disclosure: All speakers have received research grants and/or honoraria from Taiho and/or Servier.
Acknowledgements: Writing assistance was provided by Karen Yee, ApotheCom, London, UK.
Support: The symposium and publication of this article was funded by Servier. The views and opinions expressed are those of the authors and not necessarily of Servier.
Citation: EMJ. 2017;2[3]:31-37.

Meeting Summary

Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer death in the world, accounting for approximately 1.4 million new cases and almost 700,000 deaths in 2012.1 The objective of the symposium was to provide an overview of the current treatment landscape in terms of later-line therapy in metastatic CRC (mCRC) and to discuss the evidence for the various options available, including rechallenge and therapies such as trifluridine (FTD)/tipiracil (TPI) (Lonsurf®; also known as TAS-102) and regorafenib (Stivarga®). The symposium started by examining the clinical value of third-line treatment in patients with mCRC and providing an insight into the mechanism of action of FTD/TPI, and a comparison with that of 5-fluorouracil (5-FU). The safety and efficacy of FTD/TPI was then discussed together with the practical management of patients on treatment. The speakers tackled the issue of rechallenge and reintroduction as an option in the third-line, reviewing the pros and cons, and the available studies providing information on the safety and efficacy of the different options in later lines, concluding that there is a lack of robust evidence for rechallenge as a clinical decision. This was followed by a review of the compelling evidence for the use of treatments such as FTD/TPI and regorafenib in the third-line, with documented evidence for efficacy.

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