Treatment options after regorafenib failure in metastatic colorectal cancer

OBJECTIVE: In the treatment of metastatic colorectal cancer (mCRC), there is a need for a treatment option in patients who have received regorafenib (RGR) therapy and progressed, especially in patients fit enough to receive a new therapy. We aimed to compare the role of rechallenge chemotherapy (RCH CTx) with best supportive care (BSC) in mCRC patients after standard CTx and subsequent RGR treatment in terms of survival benefit. PATIENTS AND METHODS: Patients with progressive mCRC who received at least one month of subsequent RGR therapy after standard CTx treatments were included in the study. Patients were divided into two groups: receiving RCH CTx or BSC (without antitumoural therapy) after RGR failure. There were 26 patients in the RCH CTx group and 30 patients in the BSC group. The RCH CTx and BSC groups were compared for demographic and clinical features, laboratory parameters, and survival rates. RESULTS: After the RGR failure, the median overall survival (OS) for the RCH CTx (n = 26) and BSC (n = 30) groups were 7.5 (95% CI, 6.3-8.7) months and 1.2 (95% CI, 0.9-1.5) months, respectively (p < 0.001). The median OS was 7.5 (95% CI, 6.3-8.7) months for the RCH CTx (n = 26) and 1.4 (95% Cl. 0.3-2.4) months for the BSC (n = 14) groups when only the patients with an Eastern Cooperative Oncology Group Performance Status (ECOG PS) <= 2 at progression with RGR treatment were compared, respectively (p < 0.001). CONCLUSIONS: After the RGR failure, mCRC patients, especially those with a better ECOG-PS (<= 2) and adequate organ function, should be considered candidates for RCH CTx instead of BSC.