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Review
. 2020 Oct 31:12:1758835920956862.
doi: 10.1177/1758835920956862. eCollection 2020.

Practical considerations in the use of regorafenib in metastatic colorectal cancer

Fotios Loupakis  1 , Lorenzo Antonuzzo  2 , Jean-Baptiste Bachet  3 , Feng-Che Kuan  4 , Teresa Macarulla  5 , Filippo Pietrantonio  6 , Rui-Hua Xu  7 , Hiroya Taniguchi  8 , Thomas Winder  9 , Satoshi Yuki  10 , Shan Zeng  11 , Tanios Bekaii-Saab  12
Affiliations
Review

Practical considerations in the use of regorafenib in metastatic colorectal cancer

Fotios Loupakis et al. Ther Adv Med Oncol. .

Abstract

Over the past 20 years, management of patients with metastatic colorectal cancer (mCRC) has improved considerably, leading to increased overall survival and more patients eligible for third- or later-line therapy. Currently, two oral therapies are recommended in the third-line treatment of mCRC, regorafenib and trifluridine/tipiracil. Selecting the most appropriate treatment in the third-line setting poses different challenges compared with treatment selection at earlier stages. Therefore, it is important for physicians to understand and differentiate between available treatment options and to communicate the benefits and challenges of these to patients. In this narrative review, practical information on regorafenib is provided to aid physicians in their decision-making and patient communications in daily practice. We discuss the importance of appropriate patient selection and adverse events management through close patient monitoring and dose adjustments to ensure patients stay on treatment for longer and receive as much benefit as possible. We also highlight key physician-patient communication points to facilitate shared decision-making.

Keywords: adverse events; metastatic colorectal cancer; practical management; regorafenib; third line.

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Conflict of interest statement

Conflicts of interest statement: FL has held consulting/advisory roles with Amgen, Bayer, and Sanofi; is a speakers bureau member for Amgen, Bayer, Roche, and Sanofi; has received research funding from Amgen, Bayer, Merck Serono, and Roche; and has received personal fees from Amgen, Merck Serono, and Roche. J-BB has received honoraria from Amgen, AstraZeneca, Bayer, Celgene, Merck Serono, Pierre Fabre, Roche, Sanofi, Servier, and Shire; has held consulting/advisory roles with Amgen, Bayer, Merck Serono, and Servier; and has received personal fees from Amgen, Merck Serono, and Roche. FP has held consulting/advisory roles with Amgen, Bayer, Lilly, Merck Serono, Roche, Sanofi and Servier. HT has received honoraria from Bayer, Chugai Pharma, Lilly Japan, Merck Serono, Taiho Pharmaceutical, Takeda, and Yakult Honsha, and has received research funding from Boehringer Ingelheim, MSD Oncology, Otsuka, and Takeda; SY has received honoraria from Bayer Yakuhin, Bristol-Myers Squibb Japan, Chugai Pharma, Lilly Japan, Merck Serono, Ono Pharmaceutical, Sanofi, Taiho Pharmaceutical, Takeda, and Yakult Honsha. TB-S has held consulting/advisory roles with Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Genentech/Roche, Glenmark, Ipsen, Lilly, Merrimack, National Comprehensive Cancer Network, and Regeneron and Research to Practice (a Multi-tumor Regional Symposia series); has received research funding from National Comprehensive Cancer Network, National Cancer Institute, and Oncolytics; has provided expert testimony for Helsinn Therapeutics; and holds other relationships with ARMO BioSciences, Exelixis, Merck, Polaris, and SillaJen. LA, F-CK, TM, R-HX, TW and SZ have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Management of HFSR. Adapted from McLellan et al. HFSR, hand–foot skin reaction.
See this image and copyright information in PMC

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