Dr. McCollum on the Clinical Utility of Regorafenib in mCRC

A. David McCollum, MD
Published: Thursday, Nov 01, 2018



A. David McCollum, MD, attending oncologist, Baylor University Medical Center, discusses the clinical utility of regorafenib (Stivarga) in metastatic colorectal cancer (mCRC).

Trifluridine/tipiracil (Lonsurf) and regorafenib both have indications for the treatment of mCRC. Though they have never been compared head-to-head, they have each been compared with supportive care which is the standard in patients with refractory disease. Both offer an advantage for patients if used earlier enough in a patient’s course of treatment, says McCollum.

With regorafenib, there was some concern with dosing and excess toxicity. However, the ReDOS trial looked at a different dosing strategy. It started at a lower dose as opposed to the standard dose of 160 mg daily. The study started patients at 80 mg and, each week patients were on therapy, the dose was escalated to individual patient’s tolerance. The study convinced most physicians that a dose-escalation strategy showed better tolerance, explains McCollum, as more patients were able to stay on the drug for a longer period of time.


A. David McCollum, MD, attending oncologist, Baylor University Medical Center, discusses the clinical utility of regorafenib (Stivarga) in metastatic colorectal cancer (mCRC).

Trifluridine/tipiracil (Lonsurf) and regorafenib both have indications for the treatment of mCRC. Though they have never been compared head-to-head, they have each been compared with supportive care which is the standard in patients with refractory disease. Both offer an advantage for patients if used earlier enough in a patient’s course of treatment, says McCollum.

With regorafenib, there was some concern with dosing and excess toxicity. However, the ReDOS trial looked at a different dosing strategy. It started at a lower dose as opposed to the standard dose of 160 mg daily. The study started patients at 80 mg and, each week patients were on therapy, the dose was escalated to individual patient’s tolerance. The study convinced most physicians that a dose-escalation strategy showed better tolerance, explains McCollum, as more patients were able to stay on the drug for a longer period of time.



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