title: Regorafenib (BAY 73-4506) in advanced colorectal cancer: a phase I study.
abstract: BACKGROUND
  In a phase I dose-escalation study, regorafenib demonstrated tolerability and antitumour activity in solid tumour patients. The study was expanded to focus on patients with metastatic colorectal cancer (CRC).
  
  
  METHODS
  Patients received oral regorafenib 60-220 mg daily (160 mg daily in the extension cohort) in cycles of 21 days on, 7 days off treatment. Assessments included toxicity, response, pharmacokinetics and pharmacodynamics.
  
  
  RESULTS
  Thirty-eight patients with heavily pretreated CRC (median 4 prior lines of therapy, range 0-7) were enrolled in the dose-escalation and extension phases; 26 patients received regorafenib 160 mg daily. Median treatment duration was 53 days (range 7-280 days). The most common treatment-related toxicities included hand-foot skin reaction, fatigue, voice change and rash. Twenty-seven patients were evaluable for response: 1 achieved partial response and 19 had stable disease. Median progression-free survival was 107 days (95% CI, 66-161). At steady state, regorafenib and its active metabolites had similar systemic exposure. Pharmacodynamic assessment indicated decreased tumour perfusion in most patients.
  
  
  CONCLUSIONS
  Regorafenib showed tolerability and antitumour activity in patients with metastatic CRC. This expanded-cohort phase I study provided the foundation for further clinical trials of regorafenib in this patient population.
authors.affiliation: Department of Hematology and Medical Oncology, University of Bochum, Marienhospital Herne, Hölkeskampring 40, D-44625 Herne, Germany. dirk.strumberg@marienhospital-herne.de
authors.forename: D
authors.initials: D
authors.lastname: Strumberg
authors.forename: M E
authors.initials: ME
authors.lastname: Scheulen
authors.forename: B
authors.initials: B
authors.lastname: Schultheis
authors.forename: H
authors.initials: H
authors.lastname: Richly
authors.forename: A
authors.initials: A
authors.lastname: Frost
authors.forename: M
authors.initials: M
authors.lastname: Büchert
authors.forename: O
authors.initials: O
authors.lastname: Christensen
authors.forename: M
authors.initials: M
authors.lastname: Jeffers
authors.forename: R
authors.initials: R
authors.lastname: Heinig
authors.forename: O
authors.initials: O
authors.lastname: Boix
authors.forename: K
authors.initials: K
authors.lastname: Mross
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010671:Phenylurea Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D011725:Pyridines / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D011725:Pyridines; C559147:regorafenib