Udit Verma, MD, associate professor of Internal Medicine in Hematology/Oncology, UT Southwestern Medical Center, discusses managing the side effects of regorafenib in patients with metastatic colorectal cancer (mCRC).
The standard recommended dose of regorafenib is 160 mg dose per day on a three weeks on, one week off cycle.
Hand-foot-skin reaction is the side effect that requires the most management, says Verma. Reducing the dose to 120 mg may make the reaction less severe. The drug may also need to be delayed for several days.
Hand-foot-skin reaction rapidly improves, so if a patient has a reaction that is grade 3 or more, an oncologist can hold off the dose until it is grade 1 and then start it up again at 120 mg per day.
If there are still problems, the dose can be further reduced to 80 mg per day, says Verma.