Preference criteria for regorafenib in treating refractory metastatic colorectal cancer are the small tumor burden, slow growth and poor/scanty spread
Autor: | Hou Hsuan Cheng, Jeng Kai Jiang, Shih Ching Chang, Wei Shone Chen, Huann Sheng Wang, Shung Haur Yang, Yee Chao, Tsai Sheng Yang, Chun Chi Lin, Yuan Tzu Lan, Chien Chih Chen, Hung Hsin Lin, Kuo Cheng Huang, Hung Chih Hsu, Hao Wei Teng, Sheng Chieh Huang |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Oncology Adult Male medicine.medical_specialty Cancer therapy Colorectal cancer Pyridines Science Kaplan-Meier Estimate Article Metastasis 03 medical and health sciences chemistry.chemical_compound Gastrointestinal cancer 0302 clinical medicine Refractory Internal medicine Regorafenib Forest plot Medicine Humans Neoplasm Metastasis Cancer Aged Cell Proliferation Proportional Hazards Models Multidisciplinary business.industry Proportional hazards model Phenylurea Compounds Retrospective cohort study Nomogram Middle Aged medicine.disease Progression-Free Survival Tumor Burden 030104 developmental biology chemistry 030220 oncology & carcinogenesis Female business Colorectal Neoplasms |
Zdroj: | Scientific Reports Scientific Reports, Vol 11, Iss 1, Pp 1-13 (2021) |
ISSN: | 2045-2322 |
Popis: | 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: {"type":"clinical-trial","attrs":{"text":"NCT03829852","term_id":"NCT03829852"}}NCT03829852; Date of first registration (February 11, 2019). |
Databáze: | OpenAIRE |
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