Regorafenib: A Review in Metastatic Colorectal Cancer

Regorafenib (Stivarga^®) is an oral small-molecule multiple kinase inhibitor. It is indicated worldwide for patients with metastatic colorectal cancer (mCRC). In the EU and USA it is indicated for patients with mCRC who have been previously treated with, or are not considered candidates for available therapies, including fluoropyrimidine-based chemotherapy, an anti-VEGF therapy and, if RAS wild-type, an anti-EGFR therapy. In Japan, it is indicated for the treatment of unresectable, advanced/recurrent CRC. The addition of regorafenib to best supportive care prolonged median overall survival (OS; by up to 2.5 months) and progression-free survival (PFS; by up to 1.5 months) relative to the addition of placebo in double-blind phase 3 studies (CORRECT and CONCUR) in patients with mCRC who had progressed after failure of standard therapy. Health-related quality of life was not adversely affected with regorafenib relative to placebo. A large open-label phase 3 study (CONSIGN) and several large real-world studies supported the efficacy of regorafenib in this setting. Regorafenib had a generally manageable tolerability profile, which was consistent with the profile of a typical small-molecule multiple kinase inhibitor. Treatment-related adverse events (AEs), mostly of mild or moderate severity, were reported in the majority of patients receiving regorafenib, with dermatological toxicities and liver enzyme elevations among the most common AEs. Although identification of biomarkers/parameters predicting efficacy outcomes with regorafenib will help to individualize therapy, current evidence indicates that regorafenib is a valuable treatment option for patients with refractory mCRC who have a very poor prognosis.

Regorafenib in Advanced and Refractory Gastrointestinal Cancers

The European Society for Medical Oncology’s (ESMO) 18th World Congress on Gastrointestinal Cancer (WCGI) was held in Barcelona from 28th June–2nd July 2016. Presentations covered gastrointestinal (GI) cancers of every aetiology and site within the GI tract, as well as the major aspects of cancer management from screening to novel therapeutic options. Tyrosine kinase inhibitors (TKIs), with their ability to block key mechanisms required for tumour growth, featured heavily in this year’s presentations at WCGI. Data on the oral TKI regorafenib featured prominently in both poster discussion tours and oral presentations, emphasising the continuing interest in the evolution of this therapy within the clinical arsenal of physicians tackling GI cancers.