Carlos Becerra, MD, medical oncologist, Texas Oncology, discusses regorafenib (Stivarga) dosing in the treatment of patients with metastatic colorectal cancer.
Carlos Becerra, MD, medical oncologist, Texas Oncology, discusses regorafenib (Stivarga) dosing in the treatment of patients with metastatic colorectal cancer (mCRC).
The phase II ReDOS study of regorafenib in patients with mCRC demonstrated that a weekly dose-escalation schedule of the oral multikinase inhibitor was superior to the previously standard starting dose of 160 mg. The findings from this trial led to the NCCN changing their guidelines on the use of regorafenib in this patient population.
Becerra says that this is a very difficult population to treat, as their disease is highly resistant. Before ReDOS, patients who were started at the standard 160 mg dose often had to pause or discontinue treatment due to the toxicities. One of the questions going into ReDOS was whether starting at a lower dose would still deliver the same benefit. ReDOS showed that starting at 80 mg, observing the tolerance, and then escalating if appropriate, led to a dramatic increase in overall survival, Becerra says.