Evolving Colorectal Cancer Treatment Landscape
Colorectal cancer specialists discuss the effect of the SUNLIGHT trial data on the overall treatment and research landscapes.
This is a synopsis of an Insights series featuring Marwan G. Fakih, MD, of City of Hope, and Atif Hussein, MD, MMM, FACP, of Memorial Healthcare System.
Dr Fakih stated the phase 3 SUNLIGHT trial’s 10.8-month median overall survival with trifluridine/tipiracil plus bevacizumab represents an unprecedented finding for the refractory metastatic colorectal cancer third-line setting in a phase 3 study.
Considering the impressive survival benefit and hazard ratios under 0.5 for overall and progression-free survival, Dr Hussein suggested exploring the combination’s earlier introduction rather than reserving it for the third line. However, he agreed that the third line clearly represents the optimal placement currently, eliminating any debate with regorafenib as fourth-line monotherapy.
Nonetheless, Dr. Hussein remains intrigued by the unique chemotherapy backbone synergy this regimen displayed, motivating investigation of even further optimization in earlier lines. For future third-line colorectal cancer trials, Dr Fakih established the SUNLIGHT data necessitate utilizing trifluridine/tipiracil plus bevacizumab therapy as the minimum comparator arm given its new benchmark status.
In summary, Drs Fakih and Hussein concurred that beyond definitively establishing a new standard of care for refractory disease, the noteworthy SUNLIGHT trial results set a higher bar for survival outcomes in this setting. The promising chemotherapy backbone observed may justify earlier introduction pending additional research. Regardless, they agreed future third-line trial designs can no longer include inferior comparators, demanding comparison to trifluridine/tipiracil and bevacizumab combination therapy given the new overall survival yardstick demonstrated in refractory metastatic colorectal cancer management.
*Video synopsis is AI-generated and reviewed by Cancer Network editorial staff.
