Dr Stintzing on the Safety Profile of Fruquintinib in mCRC

Sebastian Stintzing, MD, professor, medicine, head, Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, discusses the utility of the quality-adjusted time without symptoms of disease or toxicity 

which evaluated treatment with fruquintinib

 (Fruzaqla) plus best supportive care (BSC) compared with placebo plus BSC in patients with metastatic colorectal cancer (mCRC), according to results from the phase 3 FRESCO-2 trial (NCT04322539).

Fruquintinib’s unique mechanism of action has sparked ongoing evaluations, one of which was presented at the 

, where researchers presented findings from a preplanned analysis focusing on Q-TWiST within the framework of FRESCO-2. This analysis sheds light on the impact of fruquintinib treatment on patients' quality of life (QOL), providing valuable insights beyond traditional survival metrics.

The established toxicity profile of fruquintinib in patients with mCRC generally depicts favorable tolerance, Stintzing begins. Drawing from experience with other VEGF inhibitors, no novel toxicities emerged with fruquintinib, and any observed toxicities were deemed highly manageable, he states. This aspect is crucial for patient care and treatment adherence, as it contributes to a better overall treatment experience, Stintzing explains.

Looking to the future trajectory of FRESCO-2, expectations include forthcoming data releases encompassing various subgroup analyses, he expands. These analyses will further elucidate the efficacy of fruquintinib in specific patient populations, potentially guiding treatment decisions and improving patient outcomes, Stintzing reports.

The significance of the Q-TWiST analysis lies in its demonstration of QOL benefits for patients receiving fruquintinib vs BSC, he continues. Regulatory bodies emphasize the importance of prolonging survival and ensuring therapies are not associated with significant toxicity, he elucidates, adding that the Q-TWiST analysis confirms that fruquintinib extends survival in patients with previously treated mCRC and allows them to maintain a high QOL. This reaffirms the agent’s potential as a valuable therapeutic option in this challenging clinical setting, providing hope for patients and clinicians alike, Stintzing concludes.

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Sebastian Stintzing, MD, discusses the Q-TWiST analysis of fruquintinib plus best supportive care in metastatic colorectal cancer.

Caprice on Racial and Ethnic Disparities in Transplant Outcomes in Hematologic Malignancies 

Teresa Caprice, PA-C, medical oncology, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, discusses the use of post-transplant cyclophosphamide to address disparities in outcomes of allogeneic hematopoietic cell transplantation (alloHCT) across racial and ethnic patient populations.

Challenges with accessibility, donor availability, and outcomes across racial and ethnic minority populations still occur for patients who are undergoing standard HCT. Although the use of post-transplant cyclophosphamide (PTCy) has improved the matching of transplant-eligible racial and ethnic minority populations to suitable donors, data on outcomes between racial and ethnic minority populations vs non-Hispanic White patients has been not been thoroughly investigated.

A retrospective analysis of 302 consecutive adult patients with hematologic malignancies undergoing haploidentical or mismatched unrelated donor (MMUD) HCT with PTCy at Moffitt Cancer Center between 2014 and 2022 were evaluated, Caprice details. The study addressed disparities in transplant outcomes between racial and ethnic minority patients and non-Hispanic White patients who received an HLA-mismatched transplant with PTCy, she explains.

The results demonstrated that the use of HLA-mismatched donor HCT with PTCy led to comparable clinical outcomes between both patient populations, which did not align with prior expectations, Caprice reports. There were no significant differences observed in any clinical outcomes between racial and ethnic minority patients and non-Hispanic White patients across all end points. Multivariate analysis further confirmed that race/ethnicity did not significantly impact the incidence of grade 2-4 acute graft-versus-host disease, moderate/severe chronic GVHD, rates of relapse, non-relapse mortality, relapse-free survival, or overall survival.

These findings suggest that the implementation of PTCy in HCT protocols has the potential to mitigate disparities in transplant outcomes. The study underscores the importance of addressing health disparities in HCT, particularly in terms of access to suitable donors and achieving equitable outcomes across diverse racial and ethnic populations, she concludes.

Teresa Caprice, PA-C, discusses the use of post-transplant cyclophosphamide to address disparities in transplant outcomes in racial and ethnic populations.

Dr Stintzing on the Background of the Q-TWiST Analysis of Fruquintinib in mCRC

Sebastian Stintzing, MD, professor, medicine, head, Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, discusses a quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) analysis of treatment with fruquintinib (Fruzaqla) plus best supportive care (BSC) compared with placebo plus BSC in patients with metastatic colorectal cancer (mCRC) based on results from the phase 3 FRESCO-2 trial (NCT04322539).

Fruquintinib stands out as a selective inhibitor targeting all 3 VEGF receptors, a characteristic validated by findings from the pivotal FRESCO-2 study, which demonstrated the agent’s capacity to extend overall survival in patients with previously treated mCRC, Stintzing begins. Due to its novelty, the agent continues to be evaluated. For example, at the 

, investigators presented information involving a pre-planned analysis that focused on Q-TWiST in the context of FRESCO-2.

Recognizing that in advanced lines of treatment, patients navigate the complex interplay between adverse effects (AEs) associated with the disease and those associated with theirtreatment, investigators sought to unveil the survival advantages of fruquintinib and the meaningfulness of this extension of life from patients’ perspectives, he expands. Patients in the Q-TWiST analysis were divided into groups receiving fruquintinib plus BSC or placebo plus BSC, Stintzing states. The Q-TWiST analysis dissects survival times into 3 distinctive phases: the period during treatment when patients my experience treatment-associated toxicities, the Time Without Symptoms and Toxicity (TWiST), and the post-progression survival period. By examining these intervals, investigators ascertained whether fruquintinib prolonged life and whether it did so without compromising patients’ well-being or progression-free state, he elucidates.

The Q-TWiST results are noteworthy, revealing a significant approximate 30% increase in Q-TWiST with fruquintinib plus BSC vs placebo plus BSC, he expands. This is a crucial insight for oncologists to consider when discussing treatment options with their patients, Stintzing explains. Specifically, Q-TWiST was extended by 2.04 months in the fruquintinib arm vs the placebo arm, at 6.25 months vs 4.21 months, Stintzing concludes.

Sebastian Stintzing, MD, discusses treatment with fruquintinib plus best supportive care in the Q-TWIST analysis in metastatic colorectal cancer.

Sebastian Stintzing, MD

Articles

Dr Stintzing on the Safety Profile of Fruquintinib in mCRC

Caprice on Racial and Ethnic Disparities in Transplant Outcomes in Hematologic Malignancies

Dr Stintzing on the Background of the Q-TWiST Analysis of Fruquintinib in mCRC