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Posted by on May 26, 2019 in Colorectal cancer | 0 comments

In a nutshell

This article reviewed the most common side effects of regorafenib (Stivarga) treatment for patients with metastatic (spread) colorectal cancer (mCRC). The author suggested methods to prevent these side effects to increase treatment adherence.

Some background

The standard treatment for mCRC is chemotherapy combined with targeted therapy. Targeted therapy attacks specific proteins of cancer cells which stops their growth. Vascular endothelial growth factor receptors (VEGF-r) are proteins on the surface of cells which stimulate the growth of new blood vessels. These are crucial for cancer growth and spread. Regorafenib (Stivarga) is a VEGF-r inhibitor. It has been shown to increase survival rates among patients with mCRC. 

However, regorafenib has also been shown to be associated with severe side effects. These include diarrhea, hypertension (high blood pressure) and hand-foot syndrome (a severe skin reaction). It is important to research how to manage and prevent these side effects to increase treatment adherence.

Methods & findings

The author reviewed the most common side effects of regorafenib treatment and the methods to prevent and treat them.

Hand-foot syndrome has been reported in approximately 17% of patients treated with regorafenib. Is commonly first appears in the first 2-4 weeks of treatment as itching of the palms and soles. It usually progresses to redness, pain, blisters, and peeling of the skin. Patients can reduce symptoms by avoiding activities that increase the rubbing of the skin (such as washing dishes). They can also avoid tight clothes, socks, or shoes and taking hot showers. Depending on the severity, urea or non-urea-based creams, local analgesics or corticosteroids can be prescribed.

Hypertension has been reported in up to 44% of patients treated with regorafenib. Patients should be instructed to monitor their blood pressure daily for the first 6 weeks. If blood pressure increases, blood pressure-lowering drugs should be prescribed.

Mild to moderate diarrhea has been reported in 34% of regorafenib-treated patients. Patients should have a lactose-free or high-fiber diet. If the patients have more than 3 stools per day, they should notify their doctor. This can prevent dehydration and electrolyte imbalance.

Other strategies to prevent severe side effects include starting treatment with a low dose and slowly increasing doses weekly. 

The bottom line

This article reviewed the most common side effects of regorafenib for patients with mCRC. 

Published By :

Oncology (Williston Park, N.Y.)

Date :

Apr 15, 2019

Original Title :

Regorafenib for Metastatic Colorectal Cancer: Common Toxicities and Prevention Strategies.

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