A randomised phase 2 study comparing different dose approaches of induction treatment of regorafenib in previously treated metastatic colorectal cancer patients (REARRANGE trial)


Por: Argilés G., Valladares-Ayerbes M., Viéitez J.M., García-Paredes B., Rodríguez-Garrote M., Rivera F., Goldberg R.M., Ciardiello F., Tabernero J.M., Goldberg R., Argilés, Tabernero J., Mulet N., Limón M.L., Valladares M., Jiménez P., Vieitez J.M., Grávalos C., García-Alfonso P., Santos C., Páez D., Tobeña M., Sastre J., García Paredes B., Benavides M., Aranda E., Cano M.T., Loupakis F., Rguez Garrote M., Guillén C., Rivera M.F., Safont J., Hiret S., Bennouna J., Pannier D., Malka D., Falcone A., Cremolini C., The

Publicada: 1 ene 2022
Resumen:
Purpose: The purpose of this article is to evaluate the safety of two regorafenib dose-escalation approaches in refractory metastatic colorectal cancer (mCRC) patients. Patients and methods: Patients with mCRC and progression during or within 3 months following their last standard chemotherapy regimen were randomised to receive the approved dose of regorafenib of 160 mg QD (arm A) or 120 mg QD (arm B) administered as 3 weeks of treatment followed by 1 week off, or 160 mg QD 1 week on/1 week off (arm C). The primary end-point was the percentage of patients with G3/G4 treatment-related adverse events (AEs) in each arm. Results: There were 299 patients randomly assigned to arm A (n = 101), arm B (n = 99), or arm C (n = 99); 297 initiated treatments (arm A n = 100, arm B n = 98, arm C n = 99: population for safety analyses). G3/4 treatment-related AEs occurred in 60%, 55%, and 54% of patients in arms A, B, and C, respectively. The most common G3/4 AEs were hypertension (19, 12, and 20 patients), fatigue (20, 14, and 15 patients), hypokalemia (11, 7, and 10 patients), and hand–foot skin reaction (8, 7, and 3 patients). Median overall survival was 7.4 (IQR 4.0–13.7) months in arm A, 8.6 (IQR 3.8–13.4) in arm B, and 7.1 (IQR 4.4–12.4) in arm C. Conclusions: The alternative regorafenib dosing schedules were feasible and safe in patients with mCRC who had been previously treated with standard therapy. There was a higher numerical improvement on the most clinically relevant AEs in the intermittent dosing arm, particularly during the relevant first two cycles. Clinicaltrials.gov identifier: NCT02835924. © 2022 The Author(s)

Filiaciones:
Argilés G.:
 Vall d'Hebron University Hospital and Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain

 Universitat Autònoma de Barcelona, Barcelona, Spain

 Memorial Sloan Kettering Cancer Center, New York, United States

Valladares-Ayerbes M.:
 Virgen del Rocío University Hospital and Institute of Biomedicine (IBIS), Sevilla, Spain

Viéitez J.M.:
 Hospital Universitario Central de Asturias, Oviedo, Spain

García-Paredes B.:
 Clínico San Carlos Hospital, Instituto de Investigación Hospital Clinico San Carlos (IdISSC) CIBERONC, Madrid, Spain

 H. Universitario Clínico San Carlos, Madrid, Spain

Rodríguez-Garrote M.:
 Ramon y Cajal University Hospital-IRYCIS, CIBERONC, Alcalá University, Madrid, Spain

Rivera F.:
 University Hospital Marqués de Valdecilla (IDIVAL) Santander, Spain

Goldberg R.M.:
 West Virgina University Cancer Institute, Morgantown, United States

Ciardiello F.:
 Università della Campania L. Vanvitelli, Italy

Tabernero J.M.:
 Vall d'Hebron University Hospital and Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain

Goldberg R.:
 West Virgina University Cancer Institute, Morgantown, United States

Argilés:
 Vall d'Hebron University Hospital and Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain

 Universitat Autònoma de Barcelona, Barcelona, Spain

 Memorial Sloan Kettering Cancer Center, New York, United States

Tabernero J.:
 Vall d'Hebron University Hospital and Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain

Mulet N.:
 Vall d'Hebron University Hospital and Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain

 Memorial Sloan Kettering Cancer Center, New York, United States

Limón M.L.:
 H. Virgen del Rocío, Sevilla, Spain

Valladares M.:
 H. Virgen del Rocío, Sevilla, Spain

Jiménez P.:
 H. Universitario Central de Asturias, Spain

Vieitez J.M.:
 H. Universitario Central de Asturias, Spain

Grávalos C.:
 Universitary Hospital 12 de Octubre, Madrid, Spain

García-Alfonso P.:
 Gregorio Marañón Hospital, Madrid, Spain

Santos C.:
 Institute Català d'Oncologia (ICO), Duran i Reynals Hospital – ONCOBELL, CIBERONC, Barcelona, Spain

Páez D.:
 H. Santa Creu i Sant Pau, Barcelona, Spain

Tobeña M.:
 Santa Creu I Sant Pau Hospital, Barcelona, Spain

 H. Santa Creu i Sant Pau, Barcelona, Spain

Sastre J.:
 H. Universitario Clínico San Carlos, Madrid, Spain

García Paredes B.:
 Clínico San Carlos Hospital, Instituto de Investigación Hospital Clinico San Carlos (IdISSC) CIBERONC, Madrid, Spain

 H. Universitario Clínico San Carlos, Madrid, Spain

Benavides M.:
 Regional University Hospital, Málaga, Spain

Aranda E.:
 Regional University Hospital, Málaga, Spain

Cano M.T.:
 IMIBIC, Reina Sofía Hospital, University of Córdoba, CIBERONC, Instituto de Salud Carlos III, Spain

Loupakis F.:
 Istituto oncologico Veneto, Italy

Rguez Garrote M.:
 H. Ramón y Cajal, Madrid, Spain

Guillén C.:
 H. Ramón y Cajal, Madrid, Spain

Rivera M.F.:
 H. Marqués de Valdecilla, Santander, Spain

Safont J.:
 H. General Universitario, Valencia, Spain

Hiret S.:
 Institut de Cancérologie de l'Ouest, France

Bennouna J.:
 University Hospital of Nantes, Digestive Oncology, Nantes, France

Pannier D.:
 Centre Oscar Lambret, France

Malka D.:
 Gustave Roussy, France

Cremolini C.:
 Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
ISSN: 09598049
Editorial
ELSEVIER SCI LTD, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 177 Número:
Páginas: 154-163
WOS Id: 000893203300001
ID de PubMed: 36335783
imagen All Open Access; Green

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