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) Journal Article


Authors: Shitara, K.; Doi, T.; Hosaka, H.; Thuss-Patience, P.; Santoro, A.; Longo, F.; Ozyilkan, O.; Cicin, I.; Park, D.; Zaanan, A.; Pericay, C.; Özgüroğlu, M.; Alsina, M.; Makris, L.; Benhadji, K. A.; Ilson, D. H.
Article Title: 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)
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.
Keywords: aged; placebo; chemotherapy; statistics; randomized controlled trial; age; gastrointestinal neoplasms; age groups; stomach neoplasms; tas-102; combination antimetabolite; trifluridine tipiracil
Journal Title: Gastric Cancer
Volume: 25
Issue: 3
ISSN: 1436-3291
Publisher: Springer  
Date Published: 2022-05-01
Start Page: 586
End Page: 597
Language: English
ACCESSION: WOS:000740186000001
DOI: 10.1007/s10120-021-01271-9
PROVIDER: wos
PMCID: PMC9013328
PUBMED: 34997449
Notes: Article -- Source: Wos
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  1. David H Ilson
    433 Ilson