400P Impact of regorafenib dose optimization on comparative outcomes in the treatment of relapsed/refractory metastatic colorectal cancer (mCRC)

Previous network meta-analyses (NMA) showed favorable overall survival (OS), progression-free (PFS), and safety profiles for regorafenib dose optimization (rego 80+) compared to best supportive care (BSC), standard dosing 160), trifluridine/tipiracil (TAS) in the treatment of relapsed/refractory mCRC. This update adds fruquintinib (fruq) as a comparator. Randomized controlled trials (RCTs) included NMA were identified via systematic literature review. Fixed random effect Bayesian frequentist Bucher NMAs used synthesize hazard ratios (HRs) OS PFS, odds adverse events (AEs). The HRs applied rego 80+ Kaplan-Meier curves from ReDOS trial estimate predicted median (mOS) PFS each treatment. Seven RCTs updated (ReDOS, CORRECT, CONCUR, RECOURSE, TERRA, Yoshino 2012, FRESCO). Findings consistent across models. Rego was vs all comparators with risk reduction >50% >3 months gain mOS BSC (statistically significant), ∼30% >2 160, TAS, fruq (Table). except fruq. For grade 3+ AEs, hypertension comparable other reported AEs; both had higher hand-foot skin reactions than but TAS highest hematological toxicities including anemia, neutropenia, febrile leukopenia.Table: 400PBucher results mediansInterventionsHR [95% CI] comparatorMedian monthsRego 80+reference9.8 [7.5, 11.9]BSC0.48 [0.28, 0.82]6.4 [2.3, 11.1]Rego 1600.72 [0.41, 1.27]7.5 [4.6, 11.9]TAS0.69 [0.40, 1.20]7.5 [4.2, 12.6]Fruq0.74 1.33]7.7 13.5] Open table new tab this indicate that is superior comparators. Its profile mostly fruq, offered advantages terms lower toxicities. Given these findings, could be considered favored option patients