Colorectal cancer (CRC) is one of most common cancers and leading causes of mortality in the USA, accounting for approximately 136,000 new cases and 50,000 deaths per year.1
For metastatic or unresectable CRC, standard first- and second-line treatments typically involve a combination of cytotoxic chemotherapies (eg, FOLFIRI [5-fluorouracil + oxaliplatin + irinotecan])2,3 and molecular targeted agents (eg, bevacizumab, cetuximab, panitumumab),4–6 which can help to improve progressionfree survival and overall survival.
However, due to the nature of the disease, many patients will progress through guideline-recommended standard regimens while maintaining a good performance status. Regorafenib, an oral multikinase inhibitor, which targets angiogenic, stromal, and oncogenic receptor tyrosine kinases, was approved by the US Food and Drug Administration in 2012 for the treatment of patients with metastatic CRC who have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti–vascular endothelial growth factor (VEGF) therapy and, if KRAS wild-type, an anti–epidermal growth factor receptor (EGFR) therapy.7
This approval was based on the CORRECT study, which demonstrated a median overall survival of 6.4 months with regorafenib vs 5.0 months with placebo (hazard ratio, 0.77; 95% confidence interval, 0.64–0.94; P=0.0052).8
Among the most common adverse effects were fatigue, hand–foot skin reaction, diarrhea, hypertension, and rash. Here, a case of an elderly patient on regorafenib who achieved stable disease for over 11 months with strategic dose modifications was presented.