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In a phase II trial of guadecitabine and irinotecan compared to regorafenib or TAS\u2010102 in pts with advanced mCRC refractory to irinotecan. Patients with mCRC refractory to irinotecan were randomized 2:1 to guadecitabine and irinotecan (Arm A) vs standard of care regorafenib or TAS\u2010102 (Arm B) on a 28\u2010day cycle. Between January 15, 2016 and October 24, 2018, 104 pts were randomized at four international sites, with 96 pts undergoing treatment, 62 in Arm A and 34 in Arm B. Median overall survival was 7.15\u2009months for Arm A and 7.66\u2009months for Arm B (HR 0.93, 95% CI: 0.58\u20131.47, <jats:italic>P<\/jats:italic>\u2009=\u2009.75). The Kaplan\u2013Meier rates of progression free survival at 4\u2009months were 32% in Arm A and 26% in Arm B. Common \u2265Grade 3 treatment related adverse events in Arm A were neutropenia (42%), anemia (18%), diarrhea (11%), compared to Arm B pts with neutropenia (12%), anemia (12%). Guadecitabine and irinotecan had similar OS compared to standard of care TAS\u2010102 or regorafenib, with evidence of target modulation. Clinical trial information: NCT01896856.<\/jats:p>","DOI":"10.1002\/ijc.34845","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T09:36:28Z","timestamp":1707298588000},"page":"1794-1801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A phase <scp>II<\/scp> study of guadecitabine combined with irinotecan vs regorafenib or <scp>TAS<\/scp>\u2010102 in irinotecan\u2010refractory metastatic colorectal cancer patients"],"prefix":"10.1002","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9601-7258","authenticated-orcid":false,"given":"Valerie","family":"Lee","sequence":"first","affiliation":[{"name":"School of Medicine Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Parkinson","sequence":"additional","affiliation":[{"name":"School of Medicine Johns Hopkins University  Baltimore Maryland 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