Fruquintinib with programmed cell death - 1 inhibitors versus triflueridine - tipiracil - 102 with bevacizumab in late-line mCRC: A retrospective cohort study based on propensity score matching.

The drugs fruquintinib combined with a programmed cell death protein-1 inhibitor, FP, and trifluridine-tipiracil plus bevacizumab, TB, have been shown to be effective in the treatment of patients with metastatic colorectal cancer (mCRC). However, no comparative studies have been done to indicate the better of the two. Thus, in this retrospective cohort study, we conducted a comparative analysis by enrolling 106 eligible patients at the Hunan Cancer Hospital, China. Based on the treatment received, 72 and 34 patients were allocated to the FP and TB cohorts, respectively. The crude overall survival was 19.4 months (95% confidence interval [CI], 17.9 to not applicable) in the FP cohort versus 11.6 months (95% CI, 10.0-17.2) in the TB cohort. The hazard ratio (HR) of FP was 0.384 (95% CI, 0.192-0.769). Multivariate Cox regression showed that the adjusted HR was 0.323 (95% CI, 0.149-0.704). Using the propensity score, we applied three statistical methods: inverse probability weighting, propensity score matching, and additional adjustment for the propensity score with multivariate Cox regression. The HRs of FP were 0.437 (95% CI, 0.200-0.953), 0.446 (95% CI, 0.201-0.990), and 0.339 (95% CI, 0.153-0.748), respectively. Subgroup analysis indicated that FP demonstrated lower HR. Additionally, in the raw set, the objective response rate was 16.67% versus 8.82%, and the disease control rate was 93.06% versus 73.53%. The FP suggested superior survival outcomes compared to TB in patients with late-line mCRC both in crude and further analyses, warranting a large-scale prospective study.