Dr. Wainberg on Optimal Dosing With Regorafenib in CRC

Zev A. Wainberg, MD, associate professor of medicine and surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), co-director, UCLA Gastrointestinal Oncology Program, director, Early Phase Clinical Research Program, Jonsson Comprehensive Cancer Center, discusses optimal dosing with regorafenib (Stivarga) in colorectal cancer (CRC).

The phase 2 ReDOS trial demonstrated comparable activity with a lower incidence of adverse effects in patients with relapsed/refractory metastatic CRC who were treated with regorafenib in a dose-escalation strategy compared with standard dosing.

Based on the data, the goal of utilizing regorafenib in patients with metastatic CRC is to provide durable responses rather than to reach the full 160 mg dose, says Wainberg. In the clinic, starting patients at 80 mg of regorafenib and escalating to 120 mg if the patient doesn’t have limiting toxicities is standard, says Wainberg. However, because only about half of patients are able to escalate to 160 mg, patients who are tolerating 120 mg without the need for dose interruptions can remain on the decreased dose, concludes Wainberg.