Multicenter phase 2 trial of TAS-102 with irinotecan and bevacizumab for previously treated metastatic colorectal cancer

The efficacy of FOLFIRI plus an antiangiogenic agent as second-line therapy for metastatic colorectal carcinoma (mCRC) is limited. TAS-102 is a novel oral antimetabolite with a distinct mechanism of action from fluoropyrimidines. The multicenter phase 2 TABAsCO trial in the United States evaluated the combination of TAS-102, irinotecan, and bevacizumab in patients with progressive mCRC after oxaliplatin and fluoropyrimidine. Objective response was seen in 23% of patients. The median progression-free survival was 7.9 months (versus 6 months in historical controls; p=0.018) and the median overall survivalwas 16.5 months. Sixty-seven percent of patients experienced grad 3 or higher treatment-related adverse events. The authors conclude that the combination of TAS-102, irinotecan, and bevacizumab is an active second-line therapy for patients with mCRC.