Treatment Considerations in Refractory CRC - Episode 8

Role of the Multikinase Inhibitor Regorafenib in mCRC

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The CORRECT trial evaluated the efficacy of the multikinase inhibitor regorafenib versus placebo in patients with metastatic colorectal cancer (mCRC) following progression on standard therapies. The regimen used in the CORRECT trial was regorafenib at 160 mg once daily for 3 weeks followed by 1 week off.

In the study, Alan P. Venook, MD, states that overall survival (OS) was improved by 1.4 months in the regorafenib group compared with placebo. In the study, the median OS was 6.4 months with regorafenib compared with 5.0 months with placebo. Additionally, John L. Marshall, MD, notes that about 40% of patients achieved disease stabilization with regorafenib.

Heinz-Josef Lenz, MD, comments that regorafenib can have toxicities that develop quickly. To avoid these adverse events, Lenz suggests initiating therapy with a reduced dose and then titrating the dose upward. Johanna Bendell, MD, and Venook initiate therapy with 80-mg regorafenib with the intention of increasing the dose. Marwan Fakih, MD, states that over 70% of the patients with mCRC in the CORRECT study who received regorafenib required dose modification.

Lenz and Venook recommend frequent follow-up for patients on regorafenib; Venook sees patients weekly and has a nurse call patients twice weekly. Fakih and Lenz stress the importance of discussing the risks and benefits of therapy with patients before initiating regorafenib.