This study investigated the effectiveness and safety of treatment with regorafenib (Stivarga) followed by cetuximab (Erbitux) in the treatment of advanced colorectal cancer. Researchers suggested that this treatment improves survival of these patients.

New treatments have become available in the past 20 years to treat metastatic (spread to other parts of the body) colorectal cancer. Surgery and chemotherapy are the standard treatment. However, chemotherapy for advanced cancers has only a limited effectiveness. Chemotherapy involves drugs that attack and kill cancer cells. This type of treatment is associated with higher rates of side effects.

Targeted therapy such as regorafenib and cetuximab affect a specific protein or gene of cancer cells. This stops the tumor from growing. The combination of more than one drug is usually associated with a stronger response. However, it is not clear if regorafenib followed by cetuximab or cetuximab followed by regorafenib sequence has better outcomes.

101 patients with advanced colorectal cancer were included. They received either regorafenib followed by cetuximab (51; group 1) or cetuximab followed by regorafenib (50; group 2). They were followed up for an average of 29 months.

Treatment improved the outcomes of 86% of the patients in both groups. The average overall survival (OS) for group 1 was 17.4 months vs 11.6 months in group 2. Patients from group 1 had a 39% higher survival than group 2. 

No significant differences were seen in terms of quality of life between both groups.

This study suggested that treatment with regorafenib followed by cetuximab improves survival of patients with advanced colorectal cancer, with manageable side effects.

This study had a limited number of participants and a short follow-up. Longer-term and larger studies are still needed. 

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