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Conference Paper: Regorafenib for metastatic colorectal cancer in community setting: a multicenter retrospective analysis in Hong Kong

TitleRegorafenib for metastatic colorectal cancer in community setting: a multicenter retrospective analysis in Hong Kong
Authors
Issue Date2015
PublisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/
Citation
The 17th ESMO (European Society for Medical Oncology) World Congress on Gastrointestinal Cancer, Barcelona, Spain, 1-4 July 2015. In Annals of Oncology, 2015, v. 26 suppl. 4, p. iv79, abstract P-270 How to Cite?
AbstractINTRODUCTION: The efficacy of regorafenib in refractory metastatic colorectal cancer has been demonstrated in two international phase III randomized controlled trials, the CORRECT and the CONCUR study, but the data in community setting is scarce. To evaluate the use of regorafenib in community setting, we perform a multicenter retrospective analysis in Hong Kong. METHODS: Patients were eligible for treatment with regorafenib if they have failed all available systemic agents including fluoropyrimidine, oxaliplatin, irinotecan, bevacizumab, and cetuximab or panitumumab if RAS wild-type tumor. Individual patient data was retrieved from the Department of Clinical Oncology and the Department of Medicine, Queen Mary Hospital and the Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong. Beside demographic, efficacy and toxicity data, pattern of prescription and treatment suspension were collected. RESULTS: From July 2013 to January 2015, 28 patients were treated with regorafenib for metastatic colorectal cancer in a non-clinical trial setting. The median age of patients was 62 (Range 45-77) and most of them had good performance status (ECOG 0-1: 89.3%). Majority of patients presented with synchronous metastasis (64.3%) and had metastases involving multiple organs at the time of regorafenib treatment (92.9%). Sixty-four percent of tumors were RAS wild-type. Patients have received a median of three prior lines of treatment and the median time interval from date of first line therapy to the start of regorafenib was 24.3 months. A total of 87 treatment cycles were prescribed in the 28 patients. Fifteen patients were started at 160mg daily and 9 of them required further dose reduction or suspension during subsequent cycles. Irrespective of the starting dose, 77% of additional dose reduction occurred at the first and second cycles. The main reason for dose reduction or treatment suspension was due to hand-foot syndrome followed by deranged liver function. For those who started at lower dose or required dose reduction during treatment, 14 of 22 patients were able to re-escalate the dose. Adverse events of any grade occurred in all patients. There was one case of grade 4 anaemia due to per rectal bleeding but no treatment related death was observed. The commonest grade 3 non-haematologic adverse event were hand-foot syndrome (25%), elevated AST (14.3%)/ ALT (10.7%), elevated bilirubin (3.6%), hypoalbuminaemia (3.6%), fatigue (3.6%), diarrhea (3.6%) and bleeding (3.6%). The most common grade 3 haematologic adverse events were anaemia (7.1%) and thrombocytopenia (3.6%). After a median follow-up of 4.9 months: 18 patients have progressed and the median progression-free survival was 3.2 months (95% CI 2.5-3.9 months) while 11 patients have died and the median survival was 6.1 months (95% CI: 1.4-10.9 months). Treatment response was uncommon and only 1 patient (3.6%) achieved a partial response and another 17 patients (60.7%) had stable disease at 8 weeks. Nine of nineteen patients were able to receive further systemic treatment after stopping regorafenib. CONCLUSION: The efficacy and toxicity profile of regorafenib in the community setting were comparable to those reported in phase III clinical trials. Dose reduction and treatment interruption was common but dose re-escalation is feasible.
DescriptionThis free journal suppl. entitled: ESMO 17th World Congress on Gastrointestinal Cancer, 1-4 July 2015, Barcelona, Spain
Poster Presentation: no. P-270
Persistent Identifierhttp://hdl.handle.net/10722/214883
ISSN
2015 Impact Factor: 9.269
2015 SCImago Journal Rankings: 4.362

 

DC FieldValueLanguage
dc.contributor.authorLam, KO-
dc.contributor.authorLee, KC-
dc.contributor.authorLee, VHF-
dc.contributor.authorSze, HCK-
dc.contributor.authorChiu, JWY-
dc.contributor.authorLeung, RCY-
dc.contributor.authorYau, T-
dc.date.accessioned2015-08-21T12:03:25Z-
dc.date.available2015-08-21T12:03:25Z-
dc.date.issued2015-
dc.identifier.citationThe 17th ESMO (European Society for Medical Oncology) World Congress on Gastrointestinal Cancer, Barcelona, Spain, 1-4 July 2015. In Annals of Oncology, 2015, v. 26 suppl. 4, p. iv79, abstract P-270-
dc.identifier.issn0923-7534-
dc.identifier.urihttp://hdl.handle.net/10722/214883-
dc.descriptionThis free journal suppl. entitled: ESMO 17th World Congress on Gastrointestinal Cancer, 1-4 July 2015, Barcelona, Spain-
dc.descriptionPoster Presentation: no. P-270-
dc.description.abstractINTRODUCTION: The efficacy of regorafenib in refractory metastatic colorectal cancer has been demonstrated in two international phase III randomized controlled trials, the CORRECT and the CONCUR study, but the data in community setting is scarce. To evaluate the use of regorafenib in community setting, we perform a multicenter retrospective analysis in Hong Kong. METHODS: Patients were eligible for treatment with regorafenib if they have failed all available systemic agents including fluoropyrimidine, oxaliplatin, irinotecan, bevacizumab, and cetuximab or panitumumab if RAS wild-type tumor. Individual patient data was retrieved from the Department of Clinical Oncology and the Department of Medicine, Queen Mary Hospital and the Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong. Beside demographic, efficacy and toxicity data, pattern of prescription and treatment suspension were collected. RESULTS: From July 2013 to January 2015, 28 patients were treated with regorafenib for metastatic colorectal cancer in a non-clinical trial setting. The median age of patients was 62 (Range 45-77) and most of them had good performance status (ECOG 0-1: 89.3%). Majority of patients presented with synchronous metastasis (64.3%) and had metastases involving multiple organs at the time of regorafenib treatment (92.9%). Sixty-four percent of tumors were RAS wild-type. Patients have received a median of three prior lines of treatment and the median time interval from date of first line therapy to the start of regorafenib was 24.3 months. A total of 87 treatment cycles were prescribed in the 28 patients. Fifteen patients were started at 160mg daily and 9 of them required further dose reduction or suspension during subsequent cycles. Irrespective of the starting dose, 77% of additional dose reduction occurred at the first and second cycles. The main reason for dose reduction or treatment suspension was due to hand-foot syndrome followed by deranged liver function. For those who started at lower dose or required dose reduction during treatment, 14 of 22 patients were able to re-escalate the dose. Adverse events of any grade occurred in all patients. There was one case of grade 4 anaemia due to per rectal bleeding but no treatment related death was observed. The commonest grade 3 non-haematologic adverse event were hand-foot syndrome (25%), elevated AST (14.3%)/ ALT (10.7%), elevated bilirubin (3.6%), hypoalbuminaemia (3.6%), fatigue (3.6%), diarrhea (3.6%) and bleeding (3.6%). The most common grade 3 haematologic adverse events were anaemia (7.1%) and thrombocytopenia (3.6%). After a median follow-up of 4.9 months: 18 patients have progressed and the median progression-free survival was 3.2 months (95% CI 2.5-3.9 months) while 11 patients have died and the median survival was 6.1 months (95% CI: 1.4-10.9 months). Treatment response was uncommon and only 1 patient (3.6%) achieved a partial response and another 17 patients (60.7%) had stable disease at 8 weeks. Nine of nineteen patients were able to receive further systemic treatment after stopping regorafenib. CONCLUSION: The efficacy and toxicity profile of regorafenib in the community setting were comparable to those reported in phase III clinical trials. Dose reduction and treatment interruption was common but dose re-escalation is feasible.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/-
dc.relation.ispartofAnnals of Oncology-
dc.rightsPre-print: Journal Title] ©: [year] [owner as specified on the article] Published by Oxford University Press [on behalf of xxxxxx]. All rights reserved. Pre-print (Once an article is published, preprint notice should be amended to): This is an electronic version of an article published in [include the complete citation information for the final version of the Article as published in the print edition of the Journal.] Post-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here].-
dc.titleRegorafenib for metastatic colorectal cancer in community setting: a multicenter retrospective analysis in Hong Kong-
dc.typeConference_Paper-
dc.identifier.emailLam, KO: lamkaon@hku.hk-
dc.identifier.emailLee, VHF: vhflee@hku.hk-
dc.identifier.emailSze, HCK: henrysze@graduate.hku.hk-
dc.identifier.emailChiu, JWY: jwychiu@hku.hk-
dc.identifier.emailLeung, RCY: cyleungr@hkucc.hku.hk-
dc.identifier.emailYau, T: tyaucc@hku.hk-
dc.identifier.authorityLam, KO=rp01501-
dc.identifier.authorityLee, VHF=rp00264-
dc.identifier.authoritySze, HCK=rp01697-
dc.identifier.authorityChiu, JWY=rp01917-
dc.identifier.authorityYau, T=rp01466-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/annonc/mdv233.267-
dc.identifier.hkuros249636-
dc.identifier.volume26-
dc.identifier.issuesuppl. 4-
dc.identifier.spageiv79, abstract P-270-
dc.identifier.epageiv79, abstract P-270-
dc.publisher.placeUnited Kingdom-

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