Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread

Abstract Given the unclear preference criteria for regorafenib in treating refractory metastatic colorectal cancer (mCRC), this study aimed to construct an algorithm in selecting right patients for regorafenib. This was a multicenter retrospective cohort study. Patients with pathology confirmed mCRC...

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Autores principales: Hung-Chih Hsu, Kuo-Cheng Huang, Wei-Shone Chen, Jeng-Kai Jiang, Shung-Haur Yang, Huann-Sheng Wang, Shih-Ching Chang, Yuan-Tzu Lan, Chun-Chi Lin, Hung-Hsin Lin, Sheng-Chieh Huang, Hou-Hsuan Cheng, Tsai-Sheng Yang, Chien-Chih Chen, Yee Chao, Hao-Wei Teng
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spelling oai:doaj.org-article:94c4253e2ad34466ac4871891f1989f12021-12-02T16:06:41ZPreference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread10.1038/s41598-021-94968-x2045-2322https://doaj.org/article/94c4253e2ad34466ac4871891f1989f12021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94968-xhttps://doaj.org/toc/2045-2322Abstract Given the unclear preference criteria for regorafenib in treating refractory metastatic colorectal cancer (mCRC), this study aimed to construct an algorithm in selecting right patients for regorafenib. This was a multicenter retrospective cohort study. Patients with pathology confirmed mCRC and administered with regorafenib for > 3 weeks were enrolled. Patients with good response were defined to have progression-free survival (PFS) of ≥ 4 months. The Kaplan–Meier plot was used to analyze survival. A Cox proportional hazards model was used to analyze univariate and multivariate prognostic factors and was visualized using forest plot. A clustering heatmap was used to classify patients according to responses. The decision tree and nomogram were used to construct the approaching algorithm. A total of 613 patients was analyzed. The median PFS and overall survival (OS) were 2.7 and 10.6 months, respectively. The partial response and stable disease rate are 2.4% and 36.4%. The interval between metastasis (M1) and regorafenib, metastatic status (number, liver, and brain), and CEA level were independent prognostics factors of PFS that classifies patients into three groups: good, bad and modest-1/modest-2 group with PFS >  = 4 months rates of 51%, 20%, 39% and 30%, respectively. Results were used to develop the decision tree and nomogram for approaching patients indicated with regorafenib. The preference criteria for regorafenib in treating patients with refractory mCRC are small tumor burden (CEA), slow growth (interval between metastasis and regorafenib) and poor/scanty spread (metastatic status: number and sites of metastasis): The 3S rules. TRIAL registration ClinicalTrials.gov Identifier: NCT03829852; Date of first registration (February 11, 2019).Hung-Chih HsuKuo-Cheng HuangWei-Shone ChenJeng-Kai JiangShung-Haur YangHuann-Sheng WangShih-Ching ChangYuan-Tzu LanChun-Chi LinHung-Hsin LinSheng-Chieh HuangHou-Hsuan ChengTsai-Sheng YangChien-Chih ChenYee ChaoHao-Wei TengNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Hung-Chih Hsu
Kuo-Cheng Huang
Wei-Shone Chen
Jeng-Kai Jiang
Shung-Haur Yang
Huann-Sheng Wang
Shih-Ching Chang
Yuan-Tzu Lan
Chun-Chi Lin
Hung-Hsin Lin
Sheng-Chieh Huang
Hou-Hsuan Cheng
Tsai-Sheng Yang
Chien-Chih Chen
Yee Chao
Hao-Wei Teng
Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
description Abstract Given the unclear preference criteria for regorafenib in treating refractory metastatic colorectal cancer (mCRC), this study aimed to construct an algorithm in selecting right patients for regorafenib. This was a multicenter retrospective cohort study. Patients with pathology confirmed mCRC and administered with regorafenib for > 3 weeks were enrolled. Patients with good response were defined to have progression-free survival (PFS) of ≥ 4 months. The Kaplan–Meier plot was used to analyze survival. A Cox proportional hazards model was used to analyze univariate and multivariate prognostic factors and was visualized using forest plot. A clustering heatmap was used to classify patients according to responses. The decision tree and nomogram were used to construct the approaching algorithm. A total of 613 patients was analyzed. The median PFS and overall survival (OS) were 2.7 and 10.6 months, respectively. The partial response and stable disease rate are 2.4% and 36.4%. The interval between metastasis (M1) and regorafenib, metastatic status (number, liver, and brain), and CEA level were independent prognostics factors of PFS that classifies patients into three groups: good, bad and modest-1/modest-2 group with PFS >  = 4 months rates of 51%, 20%, 39% and 30%, respectively. Results were used to develop the decision tree and nomogram for approaching patients indicated with regorafenib. The preference criteria for regorafenib in treating patients with refractory mCRC are small tumor burden (CEA), slow growth (interval between metastasis and regorafenib) and poor/scanty spread (metastatic status: number and sites of metastasis): The 3S rules. TRIAL registration ClinicalTrials.gov Identifier: NCT03829852; Date of first registration (February 11, 2019).
format article
author Hung-Chih Hsu
Kuo-Cheng Huang
Wei-Shone Chen
Jeng-Kai Jiang
Shung-Haur Yang
Huann-Sheng Wang
Shih-Ching Chang
Yuan-Tzu Lan
Chun-Chi Lin
Hung-Hsin Lin
Sheng-Chieh Huang
Hou-Hsuan Cheng
Tsai-Sheng Yang
Chien-Chih Chen
Yee Chao
Hao-Wei Teng
author_facet Hung-Chih Hsu
Kuo-Cheng Huang
Wei-Shone Chen
Jeng-Kai Jiang
Shung-Haur Yang
Huann-Sheng Wang
Shih-Ching Chang
Yuan-Tzu Lan
Chun-Chi Lin
Hung-Hsin Lin
Sheng-Chieh Huang
Hou-Hsuan Cheng
Tsai-Sheng Yang
Chien-Chih Chen
Yee Chao
Hao-Wei Teng
author_sort Hung-Chih Hsu
title Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
title_short Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
title_full Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
title_fullStr Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
title_full_unstemmed Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
title_sort preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/94c4253e2ad34466ac4871891f1989f1
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