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

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dc.authoridGoktasAydin, Sabin/0000-0002-0077-6971
dc.authoridkahraman, seda/0000-0002-5328-6554
dc.authoridTopcu, Atakan/0000-0002-3634-4820
dc.authoridakgul, Fahri/0000-0003-1422-1093
dc.authoridBayramgil, Ayberk/0000-0003-1782-7808
dc.authoridaykan, musa baris/0000-0001-7538-9119
dc.authoridhelvaci, kaan/0000-0002-8394-8168
dc.authorwosidAykan, Musa Barış/AEK-4253-2022
dc.authorwosidSendur, Mehmet Ali Nahit/H-7555-2014
dc.authorwosidGoktasAydin, Sabin/JAC-0864-2023
dc.authorwosidkahraman, seda/KHU-2244-2024
dc.authorwosidKavak, Engin Eren/IVH-3426-2023
dc.authorwosidaykan, musa baris/A-3746-2017
dc.authorwosidhelvaci, kaan/Y-8595-2018
dc.contributor.authorAydin, Sabin Goktas
dc.contributor.authorKavak, Engin Eren
dc.contributor.authorTopcu, Atakan
dc.contributor.authorBayramgil, Ayberk
dc.contributor.authorAkgul, Fahri
dc.contributor.authorKahraman, Seda
dc.contributor.authorAykan, Musa Baris
dc.date.accessioned2024-06-12T11:13:28Z
dc.date.available2024-06-12T11:13:28Z
dc.date.issued2023
dc.departmentTrakya Üniversitesien_US
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.en_US
dc.identifier.doi10.17305/bb.2023.9253
dc.identifier.endpage1095en_US
dc.identifier.issn2831-0896
dc.identifier.issn2831-090X
dc.identifier.issue6en_US
dc.identifier.pmid37289436en_US
dc.identifier.scopus2-s2.0-85176266462en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage1089en_US
dc.identifier.urihttps://doi.org/10.17305/bb.2023.9253
dc.identifier.urihttps://hdl.handle.net/20.500.14551/23568
dc.identifier.volume23en_US
dc.identifier.wosWOS:001101302800015en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAssoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevoen_US
dc.relation.ispartofBiomolecules And Biomedicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectRegorafeniben_US
dc.subjectMetastatic Colorectal Cancer (Mcrc)en_US
dc.subjectDose Escalationen_US
dc.subjectDose Interruptionen_US
dc.subjectProgression-Free Survival (PFS)en_US
dc.subjectOverall Survival (OS)en_US
dc.subjectEfficacyen_US
dc.subjectMonotherapyen_US
dc.subjectSafetyen_US
dc.titlePrognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center studyen_US
dc.typeArticleen_US

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