Regorafenib in patients with recurrent high-grade astrocytoma

Sied Kebir1,2,3,4, Laurel Rauschenbach3,4,5, Alexander Radbruch6

  • 1Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.

Abstract

Insights

Regorafenib showed poor efficacy in recurrent high-grade astrocytoma, with no objective responses and significant adverse events. The drug did not promote infiltrative tumor growth in this small patient group.

Area of Science:

  • Neuro-oncology
  • Cancer therapy
  • Clinical research

Background:

  • Antiangiogenic therapies have not improved outcomes for high-grade astrocytoma.
  • Resistance may involve alternative pro-angiogenic pathways.
  • Regorafenib is a multikinase inhibitor with potential to target these pathways.

Purpose of the Study:

  • To investigate the efficacy and radiographic tumor growth patterns of regorafenib in recurrent high-grade astrocytoma.
  • To assess progression-free survival (PFS), overall survival, and adverse events.
  • To analyze radiographic tumor growth patterns before and after treatment.

Main Methods:

  • Retrospective study of 6 patients with high-grade astrocytoma treated with regorafenib for at least 4 weeks.
  • Efficacy assessed by PFS, overall survival, and Common Toxicity Criteria (CTC) for adverse events.
  • Radiographic tumor growth patterns evaluated at baseline and recurrence.

Main Results:

  • Median PFS was 3.5 months (range 2.0-4.0 months) across 6 patients.
  • All patients had progressive disease, resulting in a 0% objective response rate.
  • CTC grade 3 adverse events occurred in 5 out of 6 patients; local tumor growth was the predominant pattern.

Conclusions:

  • Regorafenib demonstrated very poor performance in recurrent high-grade astrocytoma.
  • High rates of grade 3 adverse events were observed.
  • Regorafenib did not appear to promote infiltrative tumor growth.

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