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Carlos Becerra, MD, medical oncologist, Texas Oncology, discusses dosing strategies in the treatment of patients with colorectal cancer.
Carlos Becerra, MD, medical oncologist, Texas Oncology, discusses dosing strategies in the treatment of patients with colorectal cancer (CRC).
Findings from the ReDOS study, which examined a dose-escalating strategy for regorafenib (Stivarga) administration, changed the NCCN guidelines regarding the use of that agent in patients with metastatic CRC. Now, the recommended administration of regorafenib in this patient population is a dose escalation from 80 mg/daily on days 1 to 7, to 120 mg/daily on days 8 to 14, and concluding with 160 mg/daily on days 15 to 21.
Becerra says that this study indicates that the field does not have a good grasp on regorafenib, and perhaps other agents. These findings have raised questions as to whether the maximum-tolerated dose is warranted as a standard in all patients, or if titration is a more effective method. Becerra says the ladder approach lends itself to the idea of individualization, suggesting that chemotherapy dosing should be decided on a patient-by-patient basis.