Ryan B. Corcoran, MD, PhD, discusses the utility of regorafenib in colorectal cancer.
Ryan B. Corcoran, MD, PhD, associate professor of medicine, Harvard Medical School, and associate professor, Cancer Center, Massachusetts General Hospital, discusses the utility of regorafenib (Stivarga) in colorectal cancer (CRC).
In 2012, the FDA approved regorafenib for the treatment of patients with metastatic CRC whose disease has progressed after prior therapy. The regulatory decision was based on the results of the phase III CORRECT trial, which showed that the oral multikinase inhibitor improved both progression-free survival and overall survival compared with placebo.
However, significant toxicities including fatigue, hand-foot skin reaction, diarrhea, and hypertension are associated with regorafenib, says Corcoran.
The randomized phase II ReDOS study showed that a weekly regorafenib dose-escalation strategy, beginning at 80 mg and ending at 160 mg, led to more favorable toxicity in previously treated patients with metastatic CRC compared with the standard dose of 160 mg/day; quality-of-life parameters improved with the dose-escalation approach as well. As such, this is an appropriate and potentially optimal approach for this population, concludes Corcoran.