Dr. Raghav on Regorafenib Dose Optimization in CRC

Kanwal Raghav, MBBS, MD, associate professor, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses optimal dosing strategies for regorafenib (Stivarga) in patients with colorectal cancer (CRC).

Before the phase 2 ReDOS trial (NCT02368886), dose-escalation approaches were being used because the majority of patients with CRC who were treated with a high dose of regorafenib were not able to tolerate the agent very well, according to Raghav. Data from the trial have indicated it is not necessarily the highest dose of the agent that is needed, but for patients to be on the agent for a longer period of time. If this can be achieved with a dose-escalation strategy, the likelihood of keeping patients on treatment is better, Raghav says.

The phase 1 dynamics of this drug demonstrated that patients who received a 120-mg dose had equivalent dynamics to those who received a 160-mg dose, Raghav explains. It is important to escalate the dose as quickly as possible and to the highest dose level as possible, as long as patients maintain a good quality of life and their safety profile is well managed, Raghav says. This approach is now standard practice in this population, Raghav concludes.