The effectiveness and safety of regorafenib in older patients with advanced pretreated colorectal cancer

This study investigated the effectiveness and safety of regorafenib (Stivarga) treatment in older patients with colorectal cancer (CRC). Researchers suggested that this treatment has similar effects in younger and older patients.

CRC is the third most common cancer worldwide. More than half are diagnosed in patients older than 70 years. Nevertheless, the evaluation of new drugs is based on studies that mainly include younger patients. Therefore, the treatment choice for older patients is challenging due to the lack of studies.

In metastatic (spread to other parts of the body) CRC (or mCRC) surgery and chemotherapy have only limited effectiveness. Prior studies suggested that targeted therapy, such as regorafenib, improves treatment outcomes in older patients. Regorafenib targets cancer cells by stopping their growth and can improve treatment if combined with chemotherapy. However, too little is known about its effectiveness and safety in patients over the age of 70 with previously treated mCRC.

This study included information about 43 patients, with an average age of 77 years. These patients progressed after first-line treatment. The disease control rate was assessed after 2 months of regorafenib therapy. 

The 2-month disease control rate was 31.4%. The average progression-free survival (time from treatment to progression) was 2.2 months. The average overall survival was 7.5 months.

The average time to the decrease in quality of life and autonomy was around 3 months. Moderate side effects were seen in 35 patients. The most common were tiredness (45.2%), skin reaction (19%), high blood pressure (21.4%), and diarrhea (7.1%).

A trend towards disease control was observed in patients younger than 80 years. Moreover, a trend towards stopping the treatment due to side effects in patients over 80 years of age and with previously impaired autonomy, was also observed.

This study concluded that regorafenib improves treatment response in patients with previously treated mCRC over the age of 70, with manageable side effects.

This study included a small number of participants. Further studies with bigger populations are necessary.