How to take Regorafenib

The recommended dose of Regorafenib(Regorafenib) is 160 mg (four 40 mg tablets) every 28 days Take the tablet orally once daily for the first 21 days of the cycle. Swallow the entire tablet with water after a low-fat meal containing less than 600 calories and less than 30% fat. Continue treatment until disease progression or unacceptable toxicity occurs. If dose adjustment is necessary, reduce the dose in 40 mg (one tablet) increments. The lowest recommended daily dose of regorafenib is 80mg.

1. Dose Interruptions:Grade 2 hand-foot skin reaction (HFSR) [palm-plantar dysesthesia syndrome (PPES)], recurrence or lack of improvement within 7 days despite dose reduction, interruption of treatment for at least 7 days in grade 3 HFSR, symptomatic grade 2 hypertension, any grade 3 or 4 adverse reaction, worsening infection of any grade.

2. Dose reduction to120 mg: For the first onset of Grade 2 HFSR of any duration, after resolution of any Grade 3 or 4 adverse reaction except infection, for Grade 3 aspartate aminotransferase (AST)/alanine aminotransferase (ALT) elevations, resume only when the potential benefit outweighs the risk of hepatotoxicity.

3. Dose reduction to80 mg: for recurrence of Grade 2 HFSR at the 120 mg dose, after recovery of any Grade 3 or 4 adverse reactions at the 120 mg dose (except hepatotoxicity or infection).

4. Permanently discontinue dose: patients who cannot tolerate the 80 mg dose, any AST or ALT event exceeding 20 times the upper limit of normal (ULN), any occurrence of AST or ALT exceeding 3 times the ULN and bilirubin exceeding 2 times the ULN, the recurrence of AST or ALT exceeding 5 times the ULN despite the dose being reduced to 120 mg, any grade 4 adverse reactions; resumption can only be made if the potential benefits outweigh the risks.