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Introduction: While several systemic therapies are available for unresectable hepatocellular carcinoma (uHCC), there is a lack of granular real-world evidence to support the efficacy and safety of these therapies. The REFINE study evaluated safety and effectiveness of regorafenib in a global population under real-world practice conditions. This sub-analysis describes the safety and effectiveness of regorafenib among the United States (US) subset of patients in the REFINE study relative to patients in the non-US subset.
Materials And Methods: REFINE was an international, prospective, multicenter observational study. Eligible patients were those with uHCC for whom a decision to treat with regorafenib had already been made. The primary study endpoint was the frequency of documented treatment-emergent adverse events (TEAEs). Additional endpoints included overall survival and progression-free survival. Groups were compared descriptively.
Results: Of 1005 patients, 65 were from the US and 940 were from other countries. 91% of patients in the US subset (n=59) and 92% in the non-US subset (n=862) experienced ≥1 TEAE. Common adverse events (AEs) included gastrointestinal disorders, fatigue, and hand-foot skin reaction. Median overall survival for patients in the US subset was 11.4 months (interquartile range [IQR]: 4.7-25.4) and 13.2 months (IQR: 5.8-26.3) in the non-US subset. Median progression-free survival was 3.4 months (IQR: 2.4-6.1) for patients in the US subset and 3.9 months (IQR: 2.2-8.5) in the non-US subset.
Conclusion: Regorafenib was associated with similar safety and effectiveness outcomes for patients in the US and non-US subsets of the REFINE study. Differences in the incidence of certain AEs may be due to differences in treatment management between study sites or baseline disease status. These findings are consistent with the phase 3 RESORCE trial and corroborate the safety and effectiveness of regorafenib as a subsequent-line treatment in US patients with uHCC.
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http://dx.doi.org/10.2147/JHC.S459983 | DOI Listing |
Int J Biol Macromol
September 2025
Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, 200080, PR China; Shanghai Eye Diseases Prevention &Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, PR China. Electronic address
While vault RNA1-1 (vtRNA1-1) has been implicated in tumor biology, its specific role in cancer stemness and regorafenib resistance remains unexplored. In this study, we identify vtRNA1-1 as a critical regulator of cancer stemness and chemoresistance in Hepatocellular carcinoma (HCC). vtRNA1-1 enhances stemness properties by modulating the nuclear accumulation of Nanog, a core transcription factor.
View Article and Find Full Text PDFFront Oncol
August 2025
Department of Medical Oncology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
In metastatic colorectal cancer (mCRC) patients with proficient mismatch repair (pMMR)/microsatellite stability (MSS), beyond third-line therapies were extremely limited. Here, we reported a case of a 21-year-old male patient with pMMR/MSS mCRC who failed to respond to both first- and second-line treatment and subsequently received non-standard third-line therapy at a local hospital. This patient was referred to our hospital, and we initiated salvage therapies.
View Article and Find Full Text PDFFront Pharmacol
August 2025
Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Background: Colorectal cancer remains a leading cause of global cancer mortality, with metastatic CRC (mCRC) requiring sequential therapies after first line treatment failure. While regorafenib and fruquintinib are guideline-endorsed third-line options, their comparative value remains unestablished due to absent head-to-head trials. This real-world study evaluates clinical outcomes, safety, and cost differentials to model value-equilibrium pricing.
View Article and Find Full Text PDFLiver Cancer
August 2025
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Introduction: Atezolizumab-bevacizumab (Atezo-Bev) has become the standard first-line treatment for patients with unresectable hepatocellular carcinoma (uHCC). However, data on subsequent treatment after Atezo-Bev failure are lacking. We aimed to investigate the efficacy and safety of regorafenib for uHCC progression after first-line Atezo-Bev.
View Article and Find Full Text PDFLiver Cancer
August 2025
Cancer Center of Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, China.
Introduction: In the phase 3 RESORCE trial, regorafenib prolonged overall survival (OS) in patients with unresectable hepatocellular carcinoma (uHCC) whose disease progressed on prior sorafenib. The prospective, observational REFINE study aimed to evaluate the safety and effectiveness of regorafenib in a broader population of patients in real-world clinical practice, including patients with Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2, Child-Pugh B liver status, and sorafenib intolerance.
Methods: This international, prospective, multicenter study (NCT03289273) enrolled patients with uHCC for whom the decision to treat with regorafenib was made by their physician before enrollment, according to the local health authority-approved label.