Which patients have better treatment effects with regorafenib (Belvango) and evaluation criteria

In clinical application, Regorafenib (Regorafenib), as a multi-target tyrosine kinase inhibitor, is mainly used to treat patients with advanced solid tumors, including colorectal cancer, gastrointestinal stromal tumors, and some lung cancers and hepatocellular carcinomas. Studies have found that patients with slower tumor progression and good performance status (ECOGscore0-1 points) can usually obtain more obvious effects from regorafenib treatment. Such patients have strong tolerance and good drug compliance when receiving targeted therapy, so they can fully exert the anti-tumor effect of the drug.

In addition, some tumor patients with specific genetic characteristics or higher dependence on angiogenesis-related pathways tend to be more sensitive to regorafenib. For example, in patients with active angiogenesis in the tumor microenvironment, regorafenib is more effective in inhibiting tumor angiogenesis and controlling disease progression because it can effectively inhibit pathways such as VEGFR and TIE2. This also prompts doctors to screen potential beneficiaries through genetic testing and imaging evaluation before treatment.

In clinical practice, the patient's liver and kidney function status and previous treatment history are also important criteria for evaluating the efficacy. Patients who have not excessively received multiple lines of chemotherapy and whose body organ functions are acceptable can usually maintain longer progression-free survival (PFS) and overall survival (OS) on regorafenib treatment. On the contrary, if the patient's liver function is significantly impaired and the drug metabolism burden is greater, the efficacy and tolerability will often be affected. Therefore, careful evaluation is required when selecting drugs.

Finally, the criteria for evaluating the efficacy of regorafenib include not only tumor shrinkage or disease stabilization, but also the improvement of patients’ quality of life. For example, pain relief, weight maintenance, improvement of daily living abilities, etc. are all important reference indicators for judging the efficacy. Taken together, regorafenib can often achieve better clinical effects in patients with good physical condition, high gene pathway fitness, and relatively intact organ function.

Reference link:https://www.drugs.com