Regorafenib outcomes from the population based South Australian Metastatic Colorectal Cancer Registry

Abstract

Aim: Reviewing outcomes of regorafenib use in metastatic colorectal cancer using realworld data from the South Australian Metastatic Colorectal Cancer Registry. Methods: A retrospective review of the characteristics and outcomes of patients who received regorafenib in the Registry up to December 2018. The registry started in February 2006.Results: Fifty-three patients received regorafenib therapy since approved by the therapeutic goods administration in November 2013. The median age was 66 (range 34-82). 66% were male, 66% had stage IV disease at diagnosis, 53% had liver only involvement, whereas 13% had liver and lung disease and 6% had lung only involvement. 75% had left-sided primary. KRAS was available in 35/53 patients with 49% of them being WT. BRAF status was known in 8/53 with 25% of them having a mutated variant. MSI testing was known in 14 patients in whom 21% of them had MSI-High tumors. Prior lines of treatment received: one line 4%, two 9%, three 23%, four 26%, >four 37%. Prior biological use: bevacizumab 72%, anti-EGFR 100% (for RAS WT). Median survival from diagnosis was 3.3 years (95% CI, 2.8-3.8 years). Median survival from the start of regorafenib was 7.1 months (95% CI, 4.8-9.4 months) and the 12-month survival rate was 28%. Conclusion:The survival outcome for those patients from our population-based registry who access regorafenib is in keeping with reports from large, randomized trials. Thus, clinicians can quote local real world data when discussing efficacy and access to regorafenib therapy for mCRC patients.

The Evolving Role of Radiation Therapy in DLBCL: From Early-Stage to Refractory Disease

“…Our multicenter study included 90 patients. This study population had as many or more patients than many other retrospective studies [14][15][16][17] but fewer than the studies led by Yamaguchi and Adenis. 18,19 Almost half the patients in our study received regorafenib after 2 previous lines of treatment for metastatic disease, whereas the other half received it after 3 or more previous lines of therapy for metastatic disease.…”

“… CME about 75%. 14 And if you look at causes of deaths from CML, the estimated 15-year survival is close to 90% to 95%. Essentially, this disease is functionally curable, meaning that the patients will live a normal life similar to that of an age-matched normal population.…”

“…There are no clear data or guidelines on the recommended dose of bridging RT. One might consider escalating the dose in the presence of high-risk features that can predict in-field local failure, which include, but are not limited to, bulky tumor size, Myc/BCL rearrangements, 14 and high tumor metabolic volume. 18 The combination of a narrow bridging time window and late referrals to radiation oncology constitutes a major challenge for definitive bridging RT attempts.…”