Durable response using regorafenib in an elderly patient with metastatic colorectal cancer: case report

the Cancer Therapy Advisor take:

Regorafenib may provide a reduction in tumor burden and an improvement in quality of life with prolonged survival in elderly patients with KRAS wild-type, refractory metastatic colon cancer, according to a case report published in the journal Cancer Management and Research.

The case report describes a 73-year-old Indian woman who was diagnosed with left-sided stage 3B well-differentiated, KRAS wild-type adenocarcinoma of the colon with 1 of 15 positive lymph nodes.

The patient was first treated with capecitabine, oxaliplatin, and bevacizumab, but developed an anaphylactic reaction during the sixth cycle. She then received capecitabine alone for an additional 2 cycles and had no further evidence of disease on diagnostic imaging.

The patient was then restaged and was found to have metastatic disease in the peritoneum. She received cetuximab plus FOLFIRI (fluorouracil, leucovorin, irinotecan), to which she responded very well.

After no measurable signs of disease and active surveillance, the patient presented with disease progression and was restarted on cetuximab plus FOLFIRI, but achieved a mixed response.

Regorafenib 160 mg orally daily was then initiated; however, the patient developed hypertension and grade 3 fatigue and required treatment interruption.

Treatment was then restarted at 120 mg daily and reduced to 80 mg daily after developing grade 3 fatigue again. Although the patient developed disease progression, she reported improved quality of life without any incidence of side effects.

References

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Andre T, Louvet C, Maindrault-Goebel F, et al. CPT-11 (irinotecan) addition to bimonthly, high-dose leucovorin and bolus and continuousinfusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancer. GERCOR. Eur J Cancer. 1999;35(9):1343–1347.
Saltz LB, Clarke S, Díaz-Rubio E, et al. Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol. 2008;26(12):2013–2019.
Cunningham D, Humblet Y, Siena S, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. NEJM. 2004;351:337–345.
Peeters M, Price TJ, Cervantes A, et al. Randomized phase III study of panitumumab with fluorouracil, leucovorin, and irinotecan (FOLFIRI) compared with FOLFIRI alone as a second-line treatment in patients with metastatic colorectal cancer. J Clin Oncol. 2010;28(31):4706–4013.
Stivarga® (regorafenib) [package insert]. Whippany, NJ: Bayer HealthCare Pharmaceuticals Inc.; 2015.
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Source: Cancer Management and Research, originally published November 19, 2015

Topics:

Colorectal Cancer Gastrointestinal Cancer

Durable response using regorafenib in an elderly patient with metastatic colorectal cancer: case report

the Cancer Therapy Advisor take:

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