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hector-patient

*Not based on actual patient.

Meet Hector:

Age 61
Stage IV colon cancer (T4, N2, M1)
KRAS wild-type

Meet Hector*

Hector, age 61 years, was diagnosed with KRAS wild-type adenocarcinoma of the descending colon with simultaneous unresectable metastases.

Disease history

  • Diagnosed with adenocarcinoma of the left colon, with synchronous unresectable liver metastases. He was treated with right hemicolectomy followed by FOLFOX + bevacizumab
  • Disease progressed in the liver after 3 years
  • KRAS wild-type with no evidence of microsatellite instability or defective mismatch repair
  • Treated with FOLFIRI + cetuximab
  • Disease again progressed in the liver after 8 months

Relevant medical history

  • Hypertension and diabetes, both controlled with medication
    • BP: 117/76 mm Hg
    • HbA1c: 6.3%
  • ECOG performance status: 1

Treatment options for this patient

Potential treatment options for a patient with stage IV, KRAS wild-type adenocarcinoma of the left colon.

A possible alternative treatment pathway for Hector1†

Sandra-view-summary

The treatment regimens shown represent just 1 possible treatment approach for this patient. According to NCCN Guidelines®, a number of alternative treatment plans could also be used.

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

Adapted with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer V.1.2020. © 2019 National Comprehensive Cancer Network, Inc. All rights reserved. The NCCN Guidelines® and illustrations herein may not be reproduced in any form for any purpose without the express written permission of NCCN. To view the most recent and complete version of the NCCN Guidelines, go online to NCCN.org. The NCCN Guidelines are a work in progress that may be refined as often as new significant data becomes available.

ACT IN TIME in previously treated patients with mCRC to help the survival potential of their treatment journey2,3

STIVARGA®  (regorafenib) has been shown to be effective in patients with mCRC who have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti-VEGF therapy, and if KRAS wild-type, an anti-EGFR therapy.

Significant improvement in overall survival (OS) in a phase 3 trial

  • In the pivotal CORRECT trial, STIVARGA demonstrated a 6.4-month (95% CI, 5.8-7.3) overall survival (OS) rate in previously treated patients with mCRC, compared to 5.0 months (95% CI, 4.4-5.8) for placebo2
    • 23% reduction in the risk of death with STIVARGA (HR=0.77 [95% CI, 0.64-0.94; P=0.0102])2
    • There were 275 deaths out of 505 patients treated with STIVARGA (55%) vs 157 deaths out of 255 patients treated with placebo (62%)2

Significant improvement in progression-free survival (PFS) in a phase 3 trial

  • In the CORRECT trial, STIVARGA was associated with a 51% reduction in risk of progression or death compared to placebo (HR=0.49 [95% CI, 0.42-0.58; P<0.0001])2
    • Median PFS was 2.0 months (95% CI, 1.9-2.3) compared to 1.7 months (95% CI, 1.7-1.8) for placebo2
    • There were 417 deaths out of 505 patients treated with STIVARGA (83%) vs 231 deaths out of 255 patients treated with placebo (91%)2

Considerations when starting patients on STIVARGA

  • Select inclusion criteria3:
    • Eastern Cooperative Oncology Group (ECOG) performance status ≤1
    • Life expectancy of at least 3 months
    • Adequate bone marrow, liver, and renal function
  • Help patients reach the first tumor assessment by monitoring adverse events frequently3,4
    • Monitor adverse events within the first week and every 2 weeks thereafter, or more often if needed

In the CORRECT trial3:

  • 27% (n=135) and 25% (n=63) of patients received ≤2 lines of prior systemic therapy in the STIVARGA (n=505) and placebo (n=255) arms, respectively
  • 26% of patients received cytotoxic therapy after STIVARGA

CORRECT (COloRectal cancer treated with REgorafenib or plaCebo after failure of standard Therapy) was a large, international, placebo-controlled, double-blind, randomized (2:1), phase 3 trial that evaluated the efficacy and safety of STIVARGA in patients with mCRC who had progressed after all approved standard therapies (N=760).2,3