Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study

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dc.authorid0000-0002-0077-6971
dc.authorid0000-0002-0443-6966
dc.contributor.authorGöktaş Aydın, Sabin
dc.contributor.authorKavak, Engin Eren
dc.contributor.authorTopçu, Atakan
dc.contributor.authorBayramgil, Ayberk
dc.contributor.authorAkgül, Fahri
dc.contributor.authorKahraman, Seda
dc.contributor.authorAykan, Musa Barış
dc.contributor.authorAltıntaş, Yunus Emre
dc.contributor.authorHelvacı, Kaan
dc.contributor.authorÜrün, Yüksel
dc.contributor.authorBilici, Ahmet
dc.contributor.authorŞeker, Mesut
dc.date.accessioned2023-11-24T09:45:32Z
dc.date.available2023-11-24T09:45:32Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractRegorafenib, an oral multikinase inhibitor, has improved survival in metastatic colorectal cancer (mCRC) patients who have progressed on standard therapies. Our study aimed to evaluate prognostic factors influencing regorafenib treatment and assess the optimal dosing regimen in a real-life setting. We retrospectively analyzed 263 patients with mCRC from multiple medical oncology clinics in Turkey. Treatment responses and prognostic factors for survival were evaluated using univariate and multivariate analysis. Of the patients, 120 were male and 143 were female; 28.9% of tumors were located in the rectum. RAS mutations were present in 3.0% of tumors, while BRAF, K-RAS, and N-RAS mutations were found in 3.0%, 29.7%, and 25.9% of tumor tissues, respectively. Dose escalation was preferred in 105 (39.9%) patients. The median treatment duration was 3.0 months, with an objective response rate (ORR) of 4.9%. Grade ? 3 treatment-related toxicity occurred in 133 patients, leading to discontinuation, interruption, and modification rates of 50.6%, 43.7%, and 79.0%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.0 and 8.1 months, respectively. RAS/RAF mutation (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1–2.3; P = 0.01), pre-treatment carcinoembryonic antigen (CEA) levels (HR 1.6, 95% CI 1.1–2.3; P = 0.008), and toxicity-related treatment interruption or dose adjustment (HR 1.6, 95% CI 1.1–2.4; P = 0.01) were identified as independent prognostic factors for PFS. Dose escalation had no significant effect on PFS but was associated with improved OS (P < 0.001). Independent prognostic factors for OS were the initial TNM stage (HR 1.3, 95% CI 1.0–1.9; P = 0.04) and dose interruption/adjustment (HR 0.4, 95% CI 0.2–0.9; P = 0.03). Our findings demonstrate the efficacy and safety of regorafenib. Treatment line influences the response, with dose escalation being more favorable than adjustment or interruption, thus impacting survival.
dc.identifier.citationGöktaş Aydın, S., Kavak, E. E., Topçu, A., Bayramgil, A., Akgül, F., Kahraman, S. ... Şeker, M. (2023). Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study. Biomolecules and Biomedicine, 23(6), 1089-1095. https://dx.doi.org/10.17305/bb.2023.9253
dc.identifier.doi10.17305/bb.2023.9253
dc.identifier.endpage1095
dc.identifier.issn2831-090X
dc.identifier.issn2831-0896
dc.identifier.issue6
dc.identifier.pmid37289436
dc.identifier.scopus2-s2.0-85176266462
dc.identifier.scopusqualityN/A
dc.identifier.startpage1089
dc.identifier.urihttps://dx.doi.org/10.17305/bb.2023.9253
dc.identifier.urihttps://hdl.handle.net/20.500.12511/11872
dc.identifier.volume23
dc.identifier.wos001101302800015en_US
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorGöktaş Aydın, Sabin
dc.institutionauthorBilici, Ahmet
dc.language.isoen
dc.publisherAssociation of Basic Medical Sciences of FBIH
dc.relation.ispartofBiomolecules and Biomedicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectDose Escalation
dc.subjectDose Interruption
dc.subjectMetastatic Colorectal Cancer (mCRC)
dc.subjectOverall Survival (OS)
dc.subjectProgression-Free Survival (PFS)
dc.subjectRegorafenib
dc.titlePrognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study
dc.typeArticle

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