Practice patterns and outcomes with the use of regorafenib in metastatic colorectal cancer: Results from the Regorafenib in Metastatic colorectal cancer - An Indian exploratory analysis study

Anant Ramaswamy; Vikas Ostwal; Nikhil Pande; Atul Sharma; Shekar Patil; Ravi Thippeswamy; Nikhil Ghadyalpatil; Rakesh Roy; Harish Peshwe; Bhavesh Poladia; Deepan Rajamanickam; Bharat Rangarajan; PR Neelesh Reddy; Vimal Pandita; Ashis Mukherjee; Aniket Thoke; Abhijit Sarkar; CT Satish; H Shashidara; SD Banavali

doi:10.4103/sajc.sajc_173_18

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ORIGINAL ARTICLE: GI CANCERS

Year : 2019 | Volume : 8 | Issue : 1 | Page : 22-26

Practice patterns and outcomes with the use of regorafenib in metastatic colorectal cancer: Results from the Regorafenib in Metastatic colorectal cancer - An Indian exploratory analysis study

Anant Ramaswamy¹, Vikas Ostwal¹, Nikhil Pande¹, Atul Sharma², Shekar Patil³, Ravi Thippeswamy⁴, Nikhil Ghadyalpatil⁵, Rakesh Roy⁶, Harish Peshwe⁷, Bhavesh Poladia⁸, Deepan Rajamanickam⁸, Bharat Rangarajan⁹, PR Neelesh Reddy¹⁰, Vimal Pandita¹¹, Ashis Mukherjee¹², Aniket Thoke¹³, Abhijit Sarkar¹⁴, CT Satish³, H Shashidara³, SD Banavali¹
¹ Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
² Department of Medical Oncology, Dr. B. R. A IRCH, AIIMS, New Delhi, India
³ Department of Medical Oncology, HCG, Bengaluru, Karnataka, India
⁴ Department of Medical Oncology, Sri Shankara Cancer Hospital, Bengaluru, Karnataka, India
⁵ Department of Medical Oncology, Yashoda Cancer Institute, Hyderabad, Telangana, India
⁶ Saroj Gupta Cancer Centre and Research Institute, Kolkata, West Bengal, India
⁷ Department of Gastroenterology and Hepatology, Healthway Hospitals, Panjim, Goa, India
⁸ Thangam Cancer Center, Namakkal, Tamil Nadu, India
⁹ Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
¹⁰ Department of Medical Oncology, Columbia Asia Hospital, Bengaluru, Karnataka, India
¹¹ Department of Medical Oncology, Max Superspeciality Hospital, Dehradun, Uttarakhand, India
¹² Department of Oncology, Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata, West Bengal, India
¹³ Department of Oncology, Sanjeevani CBCC USA Cancer Hospital, Raipur, Chhattisgarh, India
¹⁴ Saroj Gupta Cancer Center and Research Institute, Kolkata, West Bengal, India

Correspondence Address:
Vikas Ostwal
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/sajc.sajc_173_18

Background: Regorafenib is considered a standard of care as third-line therapy in metastatic colorectal cancers (mCRCs). Materials and Methods: The study was based on a computerized clinical data form sent to oncologists across the country for entry of anonymized patient data. The data entry form was conceived and generated by the coordinating center's (Tata Memorial Hospital) gastrointestinal medical oncologists and disseminated through personal contacts at academic conferences as well as through E-mail to various oncologists across India. Results: A total of 19 physicians contributed data resulting in 80 patients receiving regorafenib who were available for the evaluation of practice patterns. The median age was 55 years (range: 24–75). Majority had received oxaliplatin-based (97.5%), irinotecan-based (87.5%), and targeted therapy (65%), previously. Patients were primarily started on reduced doses of regorafenib upfront (160 mg – 28.8%, 120 mg – 58.8%, and 80 mg – 12.5%). The median duration of treatment (treatment duration) with regorafenib was 3.1 months (range: 0.5–18), while the median progression free survival was 3.48 months (range: 2.6–4.3). Forty-five percent of patients required dose modifications due to toxicities, and the most common were (all grades) hand-foot syndrome (68.8%), fatigue (46.3%), mucositis (37.6%), and diarrhea (31.3%). Conclusions: Majority of physicians in this collaborative study from India used a lower dose of regorafenib at the outset in patients with mCRC. Despite a lower dose, there was a significant requirement for dose reduction. Duration of treatment with regorafenib as an efficacy end point in this study is similar to available data from other regions as it is the side effect profile.

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