Udit Verma, MD, associate professor of Internal Medicine in Hematology/Oncology, UT Southwestern Medical Center, discusses managing the side effects of regorafenib in patients with metastatic colorectal cancer (mCRC).

The standard recommended dose of regorafenib is 160 mg dose per day on a three weeks on, one week off cycle.

Hand-foot-skin reaction is the side effect that requires the most management, says Verma. Reducing the dose to 120 mg may make the reaction less severe. The drug may also need to be delayed for several days.

Hand-foot-skin reaction rapidly improves, so if a patient has a reaction that is grade 3 or more, an oncologist can hold off the dose until it is grade 1 and then start it up again at 120 mg per day.  

If there are still problems, the dose can be further reduced to 80 mg per day, says Verma.

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Dr. Udit Verma on Managing Regorafenib Side Effects in CRC

Udit Verma, MD, associate professor of Internal Medicine in Hematology/Oncology, UT Southwestern Medical Center, discusses a subgroup analysis of the CONSIGN study, which examined regorafenib (Stivarga) in patients with metastatic colorectal cancer (mCRC).

In the phase IIIB CONSIGN study, 2872 patients with mCRC who failed standard therapy were treated with regorafenib, which demonstrated a median progression-free survival of 2.7 months. This retrospective subgroup analysis sought to confirm previous findings as well as the safety profile of regorafenib. This study’s primary endpoint was safety, Verma adds.

The most common grade 3 adverse events were hand-foot skin reaction (16%), hypertension (15%), fatigue, and diarrhea. These findings were similar as to what was reported in the phase III CORRECT trial, Verma explains.

Udit Verma, MD, associate professor of Internal Medicine in Hematology/Oncology, UT Southwestern Medical Center, discusses a subgroup analysis of the CONSIGN study, which examined regorafenib (Stivarga) in patients with metastatic colorectal cancer. 


Udit Verma, MD

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Dr. Udit Verma on Managing Regorafenib Side Effects in CRC

Dr. Udit Verma on Regorafenib in Patients With mCRC