Dr. Overman on Choosing Between Regorafenib and TAS-102 in CRC

Michael J. Overman, MD, professor in the Department of Gastrointestinal Medical Oncology of the Division of Cancer Medicine and committee vice chair at The University of Texas MD Anderson Cancer Center, discusses factors to consider when choosing between regorafenib (Stivarga) and TAS-102 (trifluridine/tipiracil; Lonsurf) in the third-line treatment of patients with colorectal cancer.

There are no data to make clear distinctions between regorafenib and TAS-102; therefore, treatment decisions are often based on the safety profiles of the agents. In the decision-making process, we take the characteristics of the patient and their concerns into consideration, says Overman. Generally, regorafenib tends to result in many adverse events that are more challenging for patients, including fatigue; TAS-102 tends to be less toxic in that regard. However, there is no right or wrong decision when choosing among these agents, according to Overman.

Dose-escalating regorafenib may make the agent more tolerable for patients, based on the results of the ReDOS trial, which showed relatively equivalent outcomes with standard dosing and a dose-escalated approach, says Overman. The main end point of the trial was the number of patients who reached the third cycle of therapy, but several others showed similar outcomes between arms. Safety data also looked better with the dose-escalated approach, concludes Overman.