Format

Send to

Choose Destination
See comment in PubMed Commons below
Oncologist. 2014 Jun;19(6):669-80. doi: 10.1634/theoncologist.2013-0059. Epub 2014 May 12.

Optimizing treatment outcomes with regorafenib: personalized dosing and other strategies to support patient care.

Author information

1
Mayo Clinic, Rochester, Minnesota, USA; Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA; University Hospital Gasthuisberg/Leuven, Leuven, Belgium; Léon Bérard Centre and Claude Bernard University, Lyon, France; IRCCS San Martino, Genoa, Italy grothey.axel@mayo.edu suzanne_george@dfci.harvard.edu.
2
Mayo Clinic, Rochester, Minnesota, USA; Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA; University Hospital Gasthuisberg/Leuven, Leuven, Belgium; Léon Bérard Centre and Claude Bernard University, Lyon, France; IRCCS San Martino, Genoa, Italy.

Abstract

Regorafenib is an oral multikinase inhibitor that inhibits several kinases relevant to tumor biology in several cancers, including colorectal carcinoma (CRC) and gastrointestinal stromal tumor (GIST). In phase III trials, regorafenib significantly improved overall survival versus placebo in patients with metastatic CRC progressing after all available standard therapies, and significantly prolonged progression-free survival in patients with advanced GIST in whom at least imatinib and sunitinib had failed. Thus, this agent holds promise as a new standard of care for CRC and GIST patients after disease progression following all other approved therapies. The clinical trials reported to date show that this new treatment has a consistent adverse event profile that is quite different from that of traditional cytotoxic chemotherapies. The most common adverse events of regorafenib include dermatologic and mucosal toxicities (especially hand-foot skin reaction, rash, and oral mucositis), constitutional symptoms (e.g., fatigue, nausea, and weight loss), vascular effects (especially hypertension), and gastrointestinal symptoms (e.g., diarrhea). To help health care professionals anticipate and manage the adverse events associated with regorafenib, we describe our experiences in clinical trials and show that such toxicities can be effectively managed with close observation of patients from initiation of dosing, along with prompt appropriate interventions, including dose modifications, if necessary.

KEYWORDS:

Adverse events; Dose optimization; Hand-foot skin reaction; Multikinase inhibitor; Regorafenib; Supportive management

PMID:
24821824
PMCID:
PMC4041675
DOI:
10.1634/theoncologist.2013-0059
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Support Center