TY - JOUR
T1 - Efficacy and safety of regorafenib in the treatment of metastatic colorectal cancer
T2 - A systematic review
AU - Røed Skårderud, Maria
AU - Polk, Anne
AU - Kjeldgaard Vistisen, Kirsten
AU - Larsen, Finn Ole
AU - Nielsen, Dorte Lisbet
N1 - Copyright © 2017 Elsevier Ltd. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - PURPOSE: Despite advances in the treatment of colorectal cancer, third-line treatment options are still limited. Regorafenib was approved in 2012 for the treatment of patients with metastatic colorectal cancer previously treated with approved standard therapy. The purpose of this review is to present existing clinical data on regorafenib.METHOD: We systematically searched the PubMed and Embase databases, as well as ASCO and ESMO conference abstracts, for studies in English including ≥30 patients, evaluating the efficacy and safety of regorafenib in patients with metastatic colorectal cancer. A meta-analysis was conducted on the published, randomized phase III trials.RESULTS: 24 eligible studies were included. In two phase III trials, regorafenib significantly increased overall survival (OS), progression free survival (PFS), and disease control rate when compared to placebo. Survival benefits of 1.4 and 2.5 months were presented. The meta-analysis indicated a significant greater treatment effect on OS (hazard ratio 0.67) and PFS (hazard ratio 0.40), compared to placebo. The non-randomized studies mostly supported these results. The most frequently reported adverse events were hand-foot-skin reaction (25%-86%), hypertension (11%-47%) and fatigue (2%-73%).CONCLUSION: Large phase III randomized trials indicate that regorafenib provides a benefit in OS and PFS when compared to placebo. Adverse events were common, but manageable and typical of multi-target tyrosine kinase inhibitors. Further research is needed to investigate alternative approaches to the dosing of regorafenib and to explore clinical and molecular biomarkers that can guide patient selection.
AB - PURPOSE: Despite advances in the treatment of colorectal cancer, third-line treatment options are still limited. Regorafenib was approved in 2012 for the treatment of patients with metastatic colorectal cancer previously treated with approved standard therapy. The purpose of this review is to present existing clinical data on regorafenib.METHOD: We systematically searched the PubMed and Embase databases, as well as ASCO and ESMO conference abstracts, for studies in English including ≥30 patients, evaluating the efficacy and safety of regorafenib in patients with metastatic colorectal cancer. A meta-analysis was conducted on the published, randomized phase III trials.RESULTS: 24 eligible studies were included. In two phase III trials, regorafenib significantly increased overall survival (OS), progression free survival (PFS), and disease control rate when compared to placebo. Survival benefits of 1.4 and 2.5 months were presented. The meta-analysis indicated a significant greater treatment effect on OS (hazard ratio 0.67) and PFS (hazard ratio 0.40), compared to placebo. The non-randomized studies mostly supported these results. The most frequently reported adverse events were hand-foot-skin reaction (25%-86%), hypertension (11%-47%) and fatigue (2%-73%).CONCLUSION: Large phase III randomized trials indicate that regorafenib provides a benefit in OS and PFS when compared to placebo. Adverse events were common, but manageable and typical of multi-target tyrosine kinase inhibitors. Further research is needed to investigate alternative approaches to the dosing of regorafenib and to explore clinical and molecular biomarkers that can guide patient selection.
KW - Antineoplastic Agents/therapeutic use
KW - Clinical Trials, Phase III as Topic
KW - Colorectal Neoplasms/drug therapy
KW - Disease-Free Survival
KW - Fatigue/chemically induced
KW - Hand-Foot Syndrome/etiology
KW - Humans
KW - Hypertension/chemically induced
KW - Neoplasm Metastasis
KW - Phenylurea Compounds/therapeutic use
KW - Proportional Hazards Models
KW - Pyridines/therapeutic use
KW - Survival Rate
U2 - 10.1016/j.ctrv.2017.10.011
DO - 10.1016/j.ctrv.2017.10.011
M3 - Review
C2 - 29175677
SN - 0305-7372
VL - 62
SP - 61
EP - 73
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
ER -
