İstanbul Medical Journal (Mar 2019)

Treatment Outcomes of Metastatic Colorectal Cancer Patients Treated with Regorafenib as Third-Line Setting-A Multicenter Study

  • Süleyman Şahin,
  • Muhammet Bekir Hacıoğlu

DOI
https://doi.org/10.4274/imj.galenos.2018.79095
Journal volume & issue
Vol. 20, no. 2
pp. 82 – 87

Abstract

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Introduction:The clinical benefit of regorafenib therapy in metastatic colorectal cancer (mCRC) patients, who were previously treated with 5-fluorouracil (5-FU), irinotecan, or oxaliplatine based regimens with or without a biologic agent such as vascular endothelial growth factor (anti-VEGF) or anti epidermal growth factor receptor (anti-EGFR), has been shown in several previous phase III studies. In this study, we aimed to analyze the efficacy and toxicity profile of regorafenib in patients with mCRC.Methods:This was a retrospective study of 23 mCRC patients from two different centers in Turkey. All patients were treated with regorafenib as third line setting after failure of two standard consecutive therapies including 5-FU, irinotecan, or oxaliplatine with or without anti-VEGF or anti-EGFR agent. Treatment outcomes along with drug efficacy and safety were analyzed retrospectively.Results:Of the 23 patients, 13 were male (56.5%). Median age was 62 (35-76) years. The rates of RAS wild-type and RASmutated tumor were 43.5% and 56.5%, respectively. Eighteen patients (78.2%) received bevacizumab as first-line setting, whereas only five patients (28.8%) were given a prior anti-EGFR agent. Among the 23 patients, only one patient (4.3%) had a partial response. Median progression-free survival was 3.02 (2.6-3.37) months and median overall survival was 6.4 (2.6- 10.1) months. There was no prognostic factor associated with survival. Grade 3-4 toxicities were observed in 30.4% of the patients, with hand-foot skin reaction being the most frequent adverse event (42.8%).Conclusion:Although clinical and survival benefits of regorafenib have been demonstrated in previous studies, this advantage seems to be questionable in our study, with a significant toxicity profile making its use challenging. A treatment decision should be made considering the risk of mortality and toxicity profile.

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