Dr Stintzing on the Background of the Q-TWiST Analysis of Fruquintinib in mCRC

Sebastian Stintzing, MD, professor, medicine, head, Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, discusses a quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) analysis of treatment with fruquintinib (Fruzaqla) plus best supportive care (BSC) compared with placebo plus BSC in patients with metastatic colorectal cancer (mCRC) based on results from the phase 3 FRESCO-2 trial (NCT04322539).

Fruquintinib stands out as a selective inhibitor targeting all 3 VEGF receptors, a characteristic validated by findings from the pivotal FRESCO-2 study, which demonstrated the agent’s capacity to extend overall survival in patients with previously treated mCRC, Stintzing begins. Due to its novelty, the agent continues to be evaluated. For example, at the 2024 Genitourinary Cancers Symposium, investigators presented information involving a pre-planned analysis that focused on Q-TWiST in the context of FRESCO-2.

Recognizing that in advanced lines of treatment, patients navigate the complex interplay between adverse effects (AEs) associated with the disease and those associated with theirtreatment, investigators sought to unveil the survival advantages of fruquintinib and the meaningfulness of this extension of life from patients’ perspectives, he expands. Patients in the Q-TWiST analysis were divided into groups receiving fruquintinib plus BSC or placebo plus BSC, Stintzing states. The Q-TWiST analysis dissects survival times into 3 distinctive phases: the period during treatment when patients my experience treatment-associated toxicities, the Time Without Symptoms and Toxicity (TWiST), and the post-progression survival period. By examining these intervals, investigators ascertained whether fruquintinib prolonged life and whether it did so without compromising patients’ well-being or progression-free state, he elucidates.

The Q-TWiST results are noteworthy, revealing a significant approximate 30% increase in Q-TWiST with fruquintinib plus BSC vs placebo plus BSC, he expands. This is a crucial insight for oncologists to consider when discussing treatment options with their patients, Stintzing explains. Specifically, Q-TWiST was extended by 2.04 months in the fruquintinib arm vs the placebo arm, at 6.25 months vs 4.21 months, Stintzing concludes.