本研究旨在比较雷替曲塞、S-1 (RS) 和呋喹替尼联合治疗与 RS 和贝伐单抗联合治疗难治性转移性结直肠癌 (mCRC) 患者的有效性和安全性。该回顾性队列包括接受过治疗的 mCRC 患者2019年5月至2023年4月，RS联合呋喹替尼或瑞戈非尼作为三线治疗。使用倾向评分匹配（PSM）分析来平衡所有患者的基线特征。对两种方案的总生存期（OS）、无进展生存期（PFS）、肿瘤反应和安全性进行了评估。在入组的 153 名患者中，123 名患者接受 RS 加贝伐单抗，30 名患者接受 RS 加呋喹替尼。 PSM 后，分析了 30 对。与 PSM 前（5.0 个月 vs. 4.3 个月，p = 0.008）和 PSM 后（5.0 个月 vs. 4.4 个月，p = 0.012）接受 RS 加贝伐单抗治疗的患者相比，接受 RS 加呋喹替尼治疗的患者的 PFS 更长。 RS加呋喹替尼组在PSM前和PSM后也观察到更长的OS，但PSM后两组之间没有统计学差异。 PSM前RS加呋喹替尼队列的客观缓解率和疾病控制率均高于PSM前RS加贝伐单抗队列，PSM后两组之间的数值差异缩小。两组的不良反应 (AE) 均具有良好的耐受性。在难治性 mCRC 患者中，RS 加呋喹替尼表现出优于 RS 加贝伐单抗的 OS 和 PFS，且 AE 可控。© 2024 中国科克伦中心、四川大学华西医院和约翰·威利

This study aims to compare the effectiveness and safety of the combination of raltitrexed, S-1 (RS), and fruquintinib with the combination of RS and bevacizumab in patients with refractory metastatic colorectal cancer (mCRC).This retrospective cohort included mCRC patients who received the RS plus fruquintinib or regorafenib as the third-line therapy from May 2019 to April 2023. A propensity score matching (PSM) analysis was used to balance the baseline characteristics of all patients. Overall survival (OS), progression-free survival (PFS), tumor response, and safety of the two regimens were evaluated.Of the 153 patients enrolled, 123 patients received the RS plus bevacizumab and 30 patients received the RS plus fruquintinib. After PSM, 30 pairs were analyzed. Patients treated with RS plus fruquintinib had a longer PFS than those treated with RS plus bevacizumab before PSM (5.0 months vs. 4.3 months, p = 0.008) and after PSM (5.0 months vs. 4.4 months, p = 0.012). A longer OS was also observed in RS plus fruquintinib group before PSM and after PSM, but there was no statistic difference between two groups after PSM. Both objective response rate and disease control rate were higher in the RS plus fruquintinib cohort than those in the RS plus bevacizumab cohort before PSM, and the difference in values between the two groups reduced after PSM. The adverse effects (AEs) of both groups were well tolerated.In patients with refractory mCRC, RS plus fruquintinib demonstrated a superior OS, PFS than RS plus bevacizumab and had manageable AEs.© 2024 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.