Efficacy and safety of trifluridine/tipiracil in older and younger patients with metastatic gastric or gastroesophageal junction cancer: subgroup analysis of a randomized phase 3 study (TAGS)


Shitara K., Doi T., Hosaka H., Thuss-Patience P., Santoro A., Longo F., ...More

GASTRIC CANCER, vol.25, pp.586-597, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25
  • Publication Date: 2022
  • Doi Number: 10.1007/s10120-021-01271-9
  • Journal Name: GASTRIC CANCER
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.586-597
  • Keywords: Stomach neoplasms, Gastrointestinal neoplasms, Trifluridine tipiracil, Age groups, Aged, Randomized controlled trial, COMBINATION ANTIMETABOLITE, CHEMOTHERAPY, TAS-102, STATISTICS, PLACEBO, AGE
  • Istanbul University Affiliated: No

Abstract

Background Trifluridine and tipiracil (FTD/TPI) demonstrated survival benefit vs placebo and manageable safety in previously treated patients with metastatic gastric/gastroesophageal junction cancer (mGC/GEJC) in the randomized, placebo-controlled, phase 3 TAGS study. This subgroup analysis of TAGS examined efficacy/safety outcomes by age. Methods In TAGS, patients with mGC/GEJC and >= 2 prior therapies were randomized (2:1) to receive FTD/TPI 35 mg/m(2) or placebo, plus best supportive care. A preplanned subgroup analysis was performed to evaluate efficacy and safety outcomes in patients aged < 65, >= 65, and >= 75 years. Results Among 507 randomized patients (n = 337 FTD/TPI; n = 170 placebo), 55%, 45%, and 14% were aged < 65, >= 65, and >= 75 years, respectively. Overall survival hazard ratios for FTD/TPI vs placebo were 0.67 (95% CI 0.51-0.89), 0.73 (95% CI 0.52-1.02), and 0.67 (95% CI 0.33-1.37) in patients aged < 65, >= 65, and >= 75 years, respectively. Regardless of age, patients receiving FTD/TPI experienced improved progression-free survival and stayed longer on treatment than those receiving placebo. Among FTD/TPI-treated patients, frequencies of any-cause grade >= 3 adverse events (AEs) were similar across age subgroups (80% each), although grade >= 3 neutropenia was more frequent in older patients [40% (>= 65 and >= 75 years); 29% (< 65 years)]; AE-related discontinuation rates did not increase with age [14% (< 65 years), 12% (>= 65 years), and 12% (>= 75 years)]. Conclusions The results of this subgroup analysis show the efficacy and tolerability of FTD/TPI treatment regardless of age in patients with mGC/GEJC who had received 2 or more prior treatments.