Benjamin Leon Musher, MD, associate professor of medicine, hematology and oncology, at Baylor College of Medicine, discusses the role of regorafenib in the treatment of patients with advanced hepatocellular carcinoma.
Benjamin Leon Musher, MD, associate professor of medicine, hematology and oncology, Baylor College of Medicine, discusses the role of regorafenib (Stivarga) in the treatment of patients with advanced hepatocellular carcinoma (HCC).
In the phase III RESOURCE trial, patients who progressed on frontline sorafenib (Nexavar) were randomized to receive regorafenib or placebo. The trial showed a 2- to 3-month survival advantage for patients treated with regorafenib, Musher says. However, it is important to note that the drug caused similar side effects to what are seen in patients with colorectal cancer (CRC), including fatigue and hand-foot syndrome. These are toxicities that have to be taken very seriously in HCC. Notably, patients received the full dose of regorafenib which is not easily tolerated, adds Musher.
To overcome these toxicities, physicians could follow a similar path as in CRC, in which physicians administer regorafenib at a lower dose and dose-escalate pending tolerability. Musher concludes that regorafenib is now an FDA-approved second-line therapy that is a viable option in the newly crowded landscape.