Biomarkers of Trifluridine-Tipiracil Efficacy

Trifluridine/tipiracil (TAS-102) is a newer generation chemotherapy that has been approved for the later-line treatment of metastatic colorectal and gastric/gastroesophageal adenocarcinomas. The oral drug provides a modest benefit of prolongation of survival over placebo in pretreated patients with...

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Main Author: Ioannis A. Voutsadakis
Format: Article
Language:English
Published: MDPI AG 2021-11-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/23/5568
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author Ioannis A. Voutsadakis
author_facet Ioannis A. Voutsadakis
author_sort Ioannis A. Voutsadakis
collection DOAJ
description Trifluridine/tipiracil (TAS-102) is a newer generation chemotherapy that has been approved for the later-line treatment of metastatic colorectal and gastric/gastroesophageal adenocarcinomas. The oral drug provides a modest benefit of prolongation of survival over placebo in pretreated patients with these cancers with acceptable toxicity. Studies have shown rare objective responses (2–4%), and the disease control rates were 44% in both colorectal and gastric cancer randomized trials. Thus, the majority of patients progress through treatment and are burdened by toxicities. To better characterize the sub-group of patients with a higher probability of benefit from trifluridine/tipiracil, predictive biomarkers have been sought using data from randomized trials as well as from non-randomized trials and real-world series. Biomarkers examined include clinical characteristics of the patients, laboratory tests, and tumor derived biomarkers. These studies show that early neutropenia on treatment, and ratios of leukocyte subsets, are potential biomarkers able to predict trifluridine/tipiracil benefit. Combinations of laboratory values and clinical characteristics and proteins involved in trifluridine transport and activation have been examined with initial positive results.
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spelling doaj.art-6c55f0c92e6b418f975a504bb0683e5d2023-11-23T02:36:04ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011023556810.3390/jcm10235568Biomarkers of Trifluridine-Tipiracil EfficacyIoannis A. Voutsadakis0Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, CanadaTrifluridine/tipiracil (TAS-102) is a newer generation chemotherapy that has been approved for the later-line treatment of metastatic colorectal and gastric/gastroesophageal adenocarcinomas. The oral drug provides a modest benefit of prolongation of survival over placebo in pretreated patients with these cancers with acceptable toxicity. Studies have shown rare objective responses (2–4%), and the disease control rates were 44% in both colorectal and gastric cancer randomized trials. Thus, the majority of patients progress through treatment and are burdened by toxicities. To better characterize the sub-group of patients with a higher probability of benefit from trifluridine/tipiracil, predictive biomarkers have been sought using data from randomized trials as well as from non-randomized trials and real-world series. Biomarkers examined include clinical characteristics of the patients, laboratory tests, and tumor derived biomarkers. These studies show that early neutropenia on treatment, and ratios of leukocyte subsets, are potential biomarkers able to predict trifluridine/tipiracil benefit. Combinations of laboratory values and clinical characteristics and proteins involved in trifluridine transport and activation have been examined with initial positive results.https://www.mdpi.com/2077-0383/10/23/5568TAS-102biomarkerspredictivegastrointestinal cancerscolorectal
spellingShingle Ioannis A. Voutsadakis
Biomarkers of Trifluridine-Tipiracil Efficacy
Journal of Clinical Medicine
TAS-102
biomarkers
predictive
gastrointestinal cancers
colorectal
title Biomarkers of Trifluridine-Tipiracil Efficacy
title_full Biomarkers of Trifluridine-Tipiracil Efficacy
title_fullStr Biomarkers of Trifluridine-Tipiracil Efficacy
title_full_unstemmed Biomarkers of Trifluridine-Tipiracil Efficacy
title_short Biomarkers of Trifluridine-Tipiracil Efficacy
title_sort biomarkers of trifluridine tipiracil efficacy
topic TAS-102
biomarkers
predictive
gastrointestinal cancers
colorectal
url https://www.mdpi.com/2077-0383/10/23/5568
work_keys_str_mv AT ioannisavoutsadakis biomarkersoftrifluridinetipiracilefficacy