Key Takeaways from the SUNLIGHT Study in mCRC
Experts on colorectal cancer provide their key takeaways from the results from the SUNLIGHT study.
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 asked Dr Hussein to share key takeaways from the phase 3 SUNLIGHT trial and how the data have impacted his real-world metastatic colorectal cancer (mCRC) practice. Dr Hussein emphasized SUNLIGHT’s importance for defining an uncontroversial mCRC third-line standard of care, eliminating previous debate between trifluridine/tipiracil and regorafenib. He was particularly struck by the 3+ month overall survival benefit from adding bevacizumab to trifluridine/tipiracil in the third-line setting, comparing favorably to the approximately 2-month benefit of first-line bevacizumab addition. This reinforces the importance of continued angiogenesis inhibition for mCRC.
Though cross-trial comparisons have limitations, Dr. Hussein suggested the benefit applies even for the 66% of SUNLIGHT patients with RAS mutations conferring worse prognosis. He also noted that despite 43.9% and 20.3% of patients receiving first- and second-line bevacizumab, respectively, its reintroduction in the third-line setting still improved outcomes. Additional supportive endpoints like delayed ECOG performance status decline further strengthen the regimen’s value. While increased hypertension and neutropenia occurred, manageable toxicity and protection from febrile neutropenia support the combination’s favorable risk-benefit profile.
In summary, Dr. Hussein credited the SUNLIGHT trial with definitively establishing trifluridine/tipiracil plus bevacizumab as the clear mCRC third-line standard of care given its impressive survival benefit, efficacy across patient subgroups, and acceptable tolerability. Dr. Fakih agreed, adding that proactive neutropenia management and improved performance status maintenance further enhance its real-world role for improving refractory mCRC outcomes.
*Video synopsis is AI-generated and reviewed by Cancer Network editorial staff.
