171 Background: Colorectal cancer (CRC) is the second most common cause of cancer-related mortality after lung cancer. Third-line treatments for metastatic CRC (mCRC) consists of regorafenib, fruquintinib, trifluridine-tipiracil plus bevacizumab. This study aims to compare the safety and efficacy of regorafenib versus fruquintinib in the treatment of mCRC. Methods: We retrieved data from phase II/III and phase III clinical trials published between (2012-2021). A meta-analysis was conducted for the patients’ demographics, overall survival (OS), progression-free survival (PFS), and the incidence of adverse events (AEs). We reconstructed individual patient data (IPD) from Kaplan-Meier (KM) curves to allow for indirect comparisons between studies. This study strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Our study included studies with 1389 patients. Of these, 650 patients received regorafenib and 739 received fruquintinib as third line for mCRC. Analysis revealed a median OS of 7.04 months (95% CI: 6.09-8.29) in the regorafenib arm versus a median OS of 7.96 months (95% CI: 7.40-8.77), with a hazard ratio (HR) of 0.87 (95% CI: 0.76-1.01; p= 0.07) in the fruquintinib arm. On the other hand, median PFS for both regorafenib and fruquintinib arms were 2.11 months (95% CI: 1.92-2.88) and 3.70 months (95% CI: 3.67-3.78), respectively. HR 0.71 (95% CI: 0.62-0.82, p<0.001). Conclusions: The results of our study revealed PFS analyses has shown superior outcomes in the fruquintinib arm compared to regorafenib. These findings suggest that fruquintinib may offer a more favorable disease control profile. Further studies are needed to confirm these findings and to better define the optimal selection of therapy in this patient population.
Abdelrahim et al. (Sat,) studied this question.