2023-06-16 14:24:50
The results of an international clinical trial, published in «The Lancet», show that selective directed therapy, fruquintinibimproves survival in patients with metastatic colon cancer.
Colorectal cancer is one of the most common tumors in both men and women. It accounts for 15% of all tumors and presents an average survival at five years from diagnosis of 57%. According to Spanish Network of Cancer Registries (REDECAN), colorectal cancer will be the most frequently diagnosed tumor in Spain in 2023 globally with 42,721 new cases –26,357 in men and 16,364 in women. Furthermore, according to data from the Spanish Society of Medical Oncology (SEOM) is a very important cause of death, since in 2020 it was the second cause of death from tumors (15,125 deaths), only behind lung cancer (21,918 deaths).
Currently, effective approved treatments for metastatic colorectal patients who have progressed on standard therapies are in short supply, demonstrating the unmet need for new therapeutic options.
The treatment in question is called fruquintinib, an oral drug that acts selectively against vascular endothelial growth factor receptors (VEGFR 1,2 and 3), which regulate the development of new blood vessels associated with tumor growth and cancer metastasis.
In this type of colorectal cancer, the VEGF plays a very decisive role in promoting angiogenesis or the appearance of new capillaries.s. In this way, the tumor gets the necessary nutrients to continue growing. For this reason, in recent years different VEGF or VEGFR receptor inhibitors have been developed. By blocking them, it is expected to cut off this growth pathway and thus control or even reduce the size of the tumor.
The results of the study COOL-2 showed that patients receiving fruquintinib had a median survival of 7.4 months, versus 4.8 months for patients receiving placebo plus best supportive care, and a progression-free survival of 3.7 months versus 1.8 months. The reduction in deaths was 34% compared to the placebo group. At six months, 24% of patients who received fruquintinib were progression-free compared with 1% who received placebo.
Most stage IV patients have surgically unresectable disease.
The FRESCO-2 clinical trial of fruquintinib was carried out in 691 patients from 124 centers in 14 countries, including Spain. The study enrolled patients with metastatic colorectal cancer who had not responded to other treatments and who had received a median of four prior lines of therapy.
“Most stage IV patients have surgically unresectable disease,” says Cathy Eng, of the Vanderbilt University Medical Center and lead author of the study published in “The Lancet.”
Therefore, he adds, new treatment options must continue to be sought to prolong the overall survival of patients with quality of life.
“These results from the international FRESCO-2 trial validate those of the phase III FRESCO trial, conducted solely in China. Here we have an up-and-coming agent with overwhelming activity as a sole agent. I eagerly await the approval of the FDAas well as that of the European Medicines Agencys and the Japan Agency for Pharmaceuticals and Medical Devicesto be able to offer fruquintinib to all patients with metastatic colorectal cancer.”
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