ABSTRACT:
Regorafenib{first small-molecule multikinase inhibitor 3}is used for patients who had earlier treatment with multiple regimens for metastatic colorectal cancer. Here we address a female patient who is 45 year old who had stage III disease with carcinoma recto sigmoid and hemicolectomy. From November 2012 to May 2¬013, patient had 12 cycles of FOLFOX regimen as adjuvant chemotherapy and it got relapsed after 7 months , later on, 6 cycles of Irinotecan 6 5FU/LV/Avastin as a second line agent was administered. From December 2013– May 2014, she had a 6 months of PFS. On her next follow up, she showed relapse of the disease in USG abdomen and PET scan and hence initiated on regorifinib with a dose of 160 mg once daily as the third line therapy. On development of jaundice and hand foot syndrome after 2 weeks of treatment, the dose was reduced to 80mg 2 tablets/day. As she was tolerating well with the decreased dose and showed good clinical response, she was advised for regular follow up. After 22 months of revaluation, it was observed that rising CEA and CT scan showed progressive disease, hence the treatment was changed to capecitabine. Even after 50 months from the diagnosis of disease, she is still continuing in good performance status 5. The patients survival period were less than 6 months only, before the availability of these newer targeted and chemotherapuetic agents. We emphasize the fact that Regorafenib plays an significant role in the treatment of refractory metastatic colorectal cancer patients as a third line agent with meaningful improvement in the survival and minimum side effects.