Efficacy And Safety Of Fruquintinib And Regorafenib Combined With PD-1 Inhibitors In The Third-line And Beyond Treatment Of Advanced Colorectal Cancer

Background:Microsatellite stability(MSS)or mismatch repair proficient(p MMR)metastatic colorectal cancer(m CRC)is resistant to immune checkpoint inhibitors.Studies have shown that antiangiogenic drugs combined with programmed death receptor-1(PD-1)inhibitors can improve immunosuppression.The purpose of this study was to compare the efficacy of fruquintinib combined with PD-1 inhibitor(FP)and regorafenib combined with PD-1 inhibitor(RP)in the third-line and beyond treatment of advanced m CRC with MSS or p MMR.Methods:We retrospectively collected advanced MSS or p MMR m CRC patient data from The Second Affiliated Hospital of Nanchang,China,from June 2019 to March 2021.Then,we analyzed and compared the efficacy and safety of FP and RP.Results:A total of 51 patients who met the criteria were divided into FP(n = 28)and RP groups(n = 23).The overall response rate of the FP and RP groups was 7.1% and8.7% and the disease control rate was 89.3% and 56.5%,respectively.The median progression-free survival(PFS)time was higher in the FP group than in the RP group(6.4 vs.3.9 months,respectively;P = 0.0209).Patients with no liver metastasis,KRAS wild type,and left colon tumor may benefit from FP.There was no significant difference in adverse reactions between the two groups,eight patients(15.7%)had grade 3 toxicity related to treatment.Cox multivariate regression analysis showed that the treatment method was an independent risk factor for median PFS time.Conclusion:This study indicates that the combination of PD-1 inhibitors and fruquintinib has better benefits than the combination of regorafenib,and has higher theoretical significance and certain clinical reference value.