TURKISH JOURNAL OF ONCOLOGY 2022 , Vol 37 , Num 4
Toxicity Management and Effectiveness of Regorafenib in Advance GIST Patients: A Real-world Study
Nail PAKSOY1,Ferhat FERHATOĞLU1,İzzet DOĞAN1,Nijat KHANMAMMADOV1,Hamza Uğur BOZBEY2,Senem KARABULUT1,Didem TAŞTEKİN1
1Deparment of Medical Oncology, İstanbul University, Oncology Institute, İstanbul-Türkiye
2Deparment of Medical Oncology, İstanbul Yeniyuzyil University Faculty of Medicine, İstanbul-Türkiye
DOI : 10.5505/tjo.2022.3756 OBJECTIVE
Regorafenib, a multikinase inhibitor, is an approved third-line therapy for advanced gastrointestinal stromal tumors (GISTs). However, its routine clinical application is difficult due to the associated adverse events (AEs) reported by patients in the 1st month, which leads to early discontinuation. In this study, we presented our experiences in toxicities management and the effectiveness of regorafenib in our institutional cancer center.

METHODS
Twenty-two patients treated with regorafenib as a third-line therapy for advanced GISTs were retrospectively evaluated who had progressive disease after imatinib and sunitinib treatments. All patients received a full dose of 160 mg/day of regorafenib.

RESULTS
The average age of the patients was 49 years (range: 25-61 years), with a male preponderance (63.6%). The average follow-up time for the subjects was 114.2 months (16.2-210.3), while the median time of regorafenib using time was 7.7 months (1.9-29.1). The median overall survival (OS) of the patients was found as 10 months, while the 1-year OS rate was 38.3%. The median progression-free survival was found as 7.1 months. Regorafenib-related partial response was observed in 5 patients (22.7%), stable disease in 9 (40.9%), and progressive disease in 8 (36.4%). The disease control rate was 63.7%. Treatment- related grade 3/4 AEs were seen in ten (45.4%) patients. The most common AE was hand-foot skin reaction (5; 18.2%), followed by fatigue (3; 13.6%) and hypertension (2; 9.1%). Dose reductions were required in 7 patients (31.8%). The treatment was discontinued in a patient due to stroke.

CONCLUSION
Our results demonstrate promising activity and manageable side effects of regorafenib as third-line therapy of GIST in daily clinical practice in the Turkish population. Keywords : Advanced disease; adverse events; gastrointestinal stromal tumors; regorafenib