Regorafenib

Regorafenib (STIVARGA®)

🔴 Red Flags (Key Points When Using Regorafenib)

Severe hepatotoxicity (including fatal liver failure) → check LFTs before treatment and regularly during therapy
Severe bleeding risk (GI, pulmonary, intracranial, genitourinary) → discontinue if severe
GI perforation or fistula can occur → stop treatment immediately if suspected
Severe hypertension → control BP before starting and monitor regularly
Hand–foot skin reaction (HFSR) is common and dose-limiting
Impaired wound healing → interrupt before major surgery
Serious infections may occur
Reversible posterior leukoencephalopathy syndrome (RPLS) reported
Pregnancy and breastfeeding contraindicated


🔹 1. Basic Information

Generic name: Regorafenib
Brand name: STIVARGA®
Drug class: Oral multikinase inhibitor (anti-angiogenic and anti-proliferative)
Formulation: Film-coated tablets
Strength: 40 mg

Mechanism of Action:
Regorafenib inhibits multiple protein kinases involved in tumour angiogenesis, oncogenesis and the tumour microenvironment, leading to reduced tumour growth and spread.


🔹 2. FULL Oncology Indications (As per SA PIL)

STIVARGA is indicated for the treatment of the following malignancies in adult patients:

A. Metastatic Colorectal Cancer

Colon or rectal cancer that has metastasised, in patients who have:
– Received prior fluoropyrimidine-based chemotherapy, and
– Received anti-VEGF therapy, and
– If RAS wild-type, received anti-EGFR therapy, or
– Are not candidates for these treatments


B. Gastrointestinal Stromal Tumours (GIST)

Unresectable or metastatic gastrointestinal stromal tumours,
• In patients who have been previously treated with two tyrosine kinase inhibitors


C. Hepatocellular Carcinoma (HCC)

Liver cancer in patients who have been previously treated with another anticancer medicine


🔹 3. Dosing & Administration

Recommended dose (adults):
160 mg once daily (4 × 40 mg tablets)

Schedule:
• Take once daily for 3 weeks on, followed by 1 week off
• One cycle = 4 weeks

Administration:
• Take at the same time each day
• Swallow tablets whole with water
• Take after a light, low-fat meal
Avoid grapefruit juice

Continue treatment as long as clinical benefit is observed and toxicity is acceptable.


🔹 4. Dose Modifications

• Dose reductions, interruptions or permanent discontinuation may be required for toxicity
• Reduce dose stepwise based on tolerability
• Permanently discontinue for:
– Severe liver injury
– GI perforation or fistula
– Life-threatening bleeding


🔹 5. Contraindications

• Hypersensitivity to regorafenib or excipients
• Pregnancy
• Breastfeeding
• Severe gastrointestinal disorders


🔹 6. Monitoring Requirements

Liver function tests: Baseline and regularly during treatment
Blood pressure: Baseline and during therapy
Full blood count: Periodically
Electrolytes: As clinically indicated
Clinical monitoring for bleeding, infection, skin toxicity and GI symptoms


🔹 7. Side Effects (Oncology-Relevant)

Common / Very Common

• Hand–foot skin reaction
• Fatigue / asthenia
• Diarrhoea
• Decreased appetite and weight loss
• Hypertension
• Infections
• Stomatitis / mucosal inflammation
• Nausea and vomiting
• Alopecia
• Rash
• Fever

Serious

• Severe liver injury
• Severe bleeding
• Gastrointestinal perforation or fistula
• Myocardial ischaemia or infarction
• Hypertensive crisis
• Pancreatitis
• RPLS
• Stevens–Johnson syndrome / toxic epidermal necrolysis
• Secondary skin malignancies


🔹 8. Drug Interactions

• CYP3A4 inhibitors (e.g. ketoconazole) → ↑ regorafenib levels
• CYP3A4 inducers (e.g. rifampicin) → ↓ effectiveness
• Warfarin → ↑ bleeding risk
• Avoid grapefruit juice


🔹 9. Use in Special Populations

Hepatic impairment:
– Mild–moderate: use with close monitoring
– Severe: contraindicated
Renal impairment: No dose adjustment required
Elderly: No dose adjustment required
Pregnancy: Contraindicated
Breastfeeding: Contraindicated


🔹 10. Duration of Use / When to Stop

Continue until:
• Disease progression, or
• Unacceptable toxicity

Permanently discontinue if:
• Severe hepatotoxicity
• GI perforation or fistula
• Life-threatening bleeding
• Severe skin or neurological toxicity

 

https://pi-pil-repository.sahpra.org.za/wp-content/uploads/2022/11/STIVARGA-ENG-PIL-01.06.2020.pdf

Trade Name
Drug Class 1
Cost
Email
Company
Drug Rep Admin
Indications Hepatocellular Carcinoma (HCC), Colon Cancer, Gastric (stomach) Cancer
Dosage

Indications (Detailed)

Hepatocellular Carcinoma (HCC): Non-metastatic HCC
Websites:
Hepatocellular Carcinoma (HCC): Metastatic HCC
Websites:
Hepatocellular Carcinoma (HCC): Resectable HCC
Websites:
Hepatocellular Carcinoma (HCC): Non-resectable HCC
Websites:
Colon Cancer: Metastatic Colon Cancer
Websites:
Gastric (stomach) Cancer: Gastro-Intestinal Stromal Tumour (GIST)
Websites:
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