A randomised phase 2 study comparing different dose approaches of induction treatment of regorafenib in previously treated metastatic colorectal cancer patients (REARRANGE trial)

Purpose: The purpose of this article is to evaluate the safety of two regorafenib dose-escalation approaches in refractory metastatic colorectal cancer (mCRC) patients. Patients and methods: Patients with mCRC and progression during or within 3 months following their last standard chemotherapy regim...

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Autores: Argilés G., Valladares-Ayerbes M., Viéitez J.M., García-Paredes B., Rodríguez-Garrote M., Rivera F., Goldberg R.M., Ciardiello F., Tabernero J.M., Goldberg R., Argilés, Tabernero J., Mulet N., Limón M.L., Valladares M., Jiménez P., Vieitez J.M., Grávalos C., García-Alfonso P., Santos C., Páez D., Tobeña M., Sastre J., García Paredes B., Benavides M., Aranda E., Cano M.T., Loupakis F., Rguez Garrote M., Guillén C., Rivera M.F., Safont J., Hiret S., Bennouna J., Pannier D., Malka D., Falcone A., Cremolini C., The
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p15728
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=15728
https://ddd.uab.cat/record/275167
Access Level:acceso abierto
Palabra clave:aflibercept
alanine aminotransferase
bevacizumab
cetuximab
fluoropyrimidine
irinotecan
oxaliplatin
panitumumab
regorafenib
carbanilamide derivative
pyridine derivative
adult
aged
alanine aminotransferase blood level
Article
asthenia
cancer chemotherapy
cancer growth
cancer patient
cancer survival
controlled study
decreased appetite
drug dose comparison
drug dose escalation
drug safety
fatigue
female
follow up
hand foot syndrome
human
hypertension
hypokalemia
major clinical study
male
metastatic colorectal cancer
open study
overall survival
phase 2 clinical trial
proteinuria
randomized controlled trial
rash
side effect
clinical trial
colon tumor
colorectal tumor
pathology
rectum tumor
Colonic Neoplasms
Colorectal Neoplasms
Humans
Phenylurea Compounds
Pyridines
Rectal Neoplasms
Descripción
Sumario:Purpose: The purpose of this article is to evaluate the safety of two regorafenib dose-escalation approaches in refractory metastatic colorectal cancer (mCRC) patients. Patients and methods: Patients with mCRC and progression during or within 3 months following their last standard chemotherapy regimen were randomised to receive the approved dose of regorafenib of 160 mg QD (arm A) or 120 mg QD (arm B) administered as 3 weeks of treatment followed by 1 week off, or 160 mg QD 1 week on/1 week off (arm C). The primary end-point was the percentage of patients with G3/G4 treatment-related adverse events (AEs) in each arm. Results: There were 299 patients randomly assigned to arm A (n = 101), arm B (n = 99), or arm C (n = 99); 297 initiated treatments (arm A n = 100, arm B n = 98, arm C n = 99: population for safety analyses). G3/4 treatment-related AEs occurred in 60%, 55%, and 54% of patients in arms A, B, and C, respectively. The most common G3/4 AEs were hypertension (19, 12, and 20 patients), fatigue (20, 14, and 15 patients), hypokalemia (11, 7, and 10 patients), and hand–foot skin reaction (8, 7, and 3 patients). Median overall survival was 7.4 (IQR 4.0–13.7) months in arm A, 8.6 (IQR 3.8–13.4) in arm B, and 7.1 (IQR 4.4–12.4) in arm C. Conclusions: The alternative regorafenib dosing schedules were feasible and safe in patients with mCRC who had been previously treated with standard therapy. There was a higher numerical improvement on the most clinically relevant AEs in the intermittent dosing arm, particularly during the relevant first two cycles. Clinicaltrials.gov identifier: NCT02835924. © 2022 The Author(s)