ArticleBMC cancer2023
Prognostic impact of severe neutropenia in colorectal cancer patients treated with TAS-102 and bevacizumab, addressing immortal-time bias.
Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 5 citations in OpenAlex.
- Real-world outcomes and prognostic factors of trifluridine/tipiracil plus bevacizumab in metastatic colorectal cancer: a multicenter study in Spain.ESMO gastrointestinal oncology · 2026Article
- The Danish randomized trial of trifluridine-tipiracil and bevacizumab in metastatic colorectal cancer: final survival andESMO gastrointestinal oncology · 2026Article
- Relative Dose Intensity and Clinical Outcomes of Using Trifluridine/Tipiracil with or without Bevacizumab in Patients Aged ≥ 75 Years with Advanced or Recurrent Colorectal Cancer: a Single-Center Retrospective Study.Journal of gastrointestinal cancer · 2026Article
- Impact of TAS-102 dose reduction on severe neutropenia and survival outcomes in patients with metastatic colorectal cancer and prior chemotherapy-induced neutropenia.Molecular and clinical oncology · 2026Article
- Prognostic impact and risk factors of severe neutropenia in the early phase of treatment with trifluridine-tipiracil for metastatic colorectal cancer patients: a single-center retrospective study.International journal of colorectal disease · 2025Article
- Pharmacist intervention and identification of adverse events related to treatment efficacy in cancer chemotherapy to improve clinical outcomes.Journal of pharmaceutical health care and sciences · 2024Review
- Signal mining and analysis of trifluridine/tipiracil adverse events based on real-world data from the FAERS database.Frontiers in pharmacology · 2024Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have reported an association between severe neutropenia and long-term survival in patients treated with trifluridine-tipiracil (TAS-102). Because some of these studies failed to address immortality time bias, however, their findings should be interpreted with caution. Additionally, the association between severe neutropenia and survival in patients receiving TAS-102 in combination with bevacizumab (Bmab) remains unclear. PATIENTS AND
methodsWe conducted a single-center retrospective cohort study in patients with colorectal cancer who received Bmab + TAS-102. We compared overall survival (OS) between patients who developed grade ≥ 3 neutropenia during the treatment period and those who did not. To account for immortal time bias, we used two approaches, time-varying Cox regression and landmark analysis.
resultsMedian OS was 15.3 months [95% CI: 14.1-NA] in patients with grade ≥ 3 neutropenia and 10.0 months [95% CI: 8.1-NA] in those without. In time-varying Cox regression, onset grade ≥ 3 neutropenia was significantly related to longer survival after adjustment for age and modified Glasgow Prognostic Score. Additionally, 30-, 60-, 90-, and 120-day landmark analysis showed that grade ≥ 3 neutropenia was associated with longer survival after adjustment for age and modified Glasgow Prognostic Score, with respective HRs of 0.30 [0.10-0.90], 0.65 [0.30-1.42], 0.39 [0.17-0.90], and 0.41 [0.18-0.95].
conclusionWe identified an association between long-term survival and the development of severe neutropenia during the early cycle of Bmab + TAS-102 using an approach that addressed immortality time bias.
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