PMID- 31911828
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220412
IS  - 2045-3329 (Print)
IS  - 2045-3329 (Electronic)
IS  - 2045-3329 (Linking)
VI  - 10
DP  - 2020
TI  - Toxicity management of regorafenib in patients with gastro-intestinal stromal 
      tumour (GIST) in a tertiary cancer centre.
PG  - 1
LID - 10.1186/s13569-019-0123-4 [doi]
LID - 1
AB  - BACKGROUND: Regorafenib is a multi-kinase inhibitor approved as third line 
      treatment for metastatic GIST. Dose limiting toxicities are frequently seen and 
      many patients require dose reductions. This study aimed to evaluate regorafenib 
      toxicities and their management in a real-world GIST population. METHODS: 
      Retrospective review of a prospectively maintained database identified 50 
      patients with GIST treated with regorafenib at our centre between March 2013 and 
      September 2018. RESULTS: Median progression free survival (PFS) was 7.7 months 
      [interquartile range (IQR) 2.8-14.4 months]. Median overall survival (OS) from 
      start of regorafenib to death or last follow up was 15.7 months (IQR 
      9.2-28.4 months). Baseline median Eastern Cooperative Oncology Group (ECOG) 
      performance status on starting regorafenib was 1. The main reason for 
      discontinuing regorafenib was progressive disease (PD) (31/50 [62%]) rather than 
      toxicity (10/50 [20%]). Grade 3-4 adverse events (AEs) were seen in 23/50 (46%) 
      patients; palmar-plantar erythrodysesthesia (PPE) was most frequently seen (9/50 
      (18%)). Two patients died whilst on treatment with regorafenib from multi-organ 
      failure secondary to sepsis (4%). Dose reductions were required in 19/50 patients 
      (38%) and 8/50 (16%) patients started regorafenib at a lower dose band than the 
      recommended dose (160 mg) due to comorbidities or concern over a higher 
      individual risk of toxicity. CONCLUSION: Although PD was the main reason for 
      discontinuing treatment, toxicity management and dosing of regorafenib remains 
      critical. Median duration of treatment was longer compared to previous studies 
      suggesting a durable clinical benefit with regorafenib with rigorous toxicity 
      management.
CI  - (c) The Author(s) 2020.
FAU - Chamberlain, Florence
AU  - Chamberlain F
AUID- ORCID: 0000-0001-7583-1341
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Farag, Sheima
AU  - Farag S
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Williams-Sharkey, Constance
AU  - Williams-Sharkey C
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Collingwood, Cecilia
AU  - Collingwood C
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Chen, Lucia
AU  - Chen L
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Mansukhani, Sonia
AU  - Mansukhani S
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Engelmann, Bodil
AU  - Engelmann B
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Al-Muderis, Omar
AU  - Al-Muderis O
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Chauhan, Dharmisha
AU  - Chauhan D
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Thway, Khin
AU  - Thway K
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
AD  - 2The Institute of Cancer Research, London, SW7 3RP UK. ISNI: 0000 0001 1271 4623. 
      GRID: grid.18886.3f
FAU - Fisher, Cyril
AU  - Fisher C
AD  - 2The Institute of Cancer Research, London, SW7 3RP UK. ISNI: 0000 0001 1271 4623. 
      GRID: grid.18886.3f
AD  - 3University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW UK. 
      ISNI: 0000 0004 0376 6589. GRID: grid.412563.7
FAU - Jones, Robin L
AU  - Jones RL
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
AD  - 2The Institute of Cancer Research, London, SW7 3RP UK. ISNI: 0000 0001 1271 4623. 
      GRID: grid.18886.3f
FAU - Gennatas, Spyridon
AU  - Gennatas S
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
FAU - Benson, Charlotte
AU  - Benson C
AD  - 1Sarcoma Unit, The Royal Marsden NHS Foundation Trust, London, SW6 3JJ UK. ISNI: 
      0000 0001 0304 893X. GRID: grid.5072.0
LA  - eng
PT  - Journal Article
DEP - 20200104
PL  - England
TA  - Clin Sarcoma Res
JT  - Clinical sarcoma research
JID - 101577890
PMC - PMC6942401
OTO - NOTNLM
OT  - Gastro-intestinal stromal tumour
OT  - Regorafenib
OT  - Sarcoma
OT  - Soft tissue sarcoma
OT  - Toxicity management
COIS- Competing interestsRLJ: Receipt of honoraria and consultation fees (Adaptimmune; 
      Blueprint; Clinigen; Eisai; Epizyme; Daichii; Deciphera; Immunedesign; Lilly; 
      Merck; Pharmamar). The rest of the authors declare that they have no competing 
      interests.
EDAT- 2020/01/09 06:00
MHDA- 2020/01/09 06:01
PMCR- 2020/01/04
CRDT- 2020/01/09 06:00
PHST- 2019/09/14 00:00 [received]
PHST- 2019/12/10 00:00 [accepted]
PHST- 2020/01/09 06:00 [entrez]
PHST- 2020/01/09 06:00 [pubmed]
PHST- 2020/01/09 06:01 [medline]
PHST- 2020/01/04 00:00 [pmc-release]
AID - 123 [pii]
AID - 10.1186/s13569-019-0123-4 [doi]
PST - epublish
SO  - Clin Sarcoma Res. 2020 Jan 4;10:1. doi: 10.1186/s13569-019-0123-4. eCollection 
      2020.