Medical Information

Regorafenib is a multi kinase inhibitor suitable for the treatment of malignant tumors such as metastatic colorectal cancer and hepatocellular carcinoma. It should be noted that there are limitations such as liver function damage and bleeding risk, and it interacts with drugs such as CYP3A4 inhibitors/inducers.

1. Applicable population

(1) Metastatic colorectal cancer: Adult patients who have previously received treatment with fluorouracil, oxaliplatin, and irinotecan.

(2) Hepatocellular carcinoma: Adult patients who have previously received sorafenib treatment.

(3) Gastrointestinal stromal tumor: Adult patients who have previously received treatment with imatinib and sunitinib.

2. Restrictive conditions

(1) Liver function impairment: Severe impairment (Child Pugh C grade) is contraindicated, moderate impairment requires reduction.

(2) Bleeding risk: Use with caution in patients with active bleeding or recent bleeding history.

(3) Hypertension: Blood pressure should be controlled before treatment and monitored weekly during the treatment period.

(4) Skin toxicity: Hand and foot skin reactions are common and require timely intervention.

3. Drug interactions

(1) Strong CYP3A4 inhibitors (such as ketoconazole): may increase exposure to regorafenib and should be avoided in combination or reduced.

(2) CYP3A4 inducers (such as rifampicin): may reduce the efficacy of regorafenib and alternative drugs need to be considered.

(3) UGT1A9 inhibitor: may increase the concentration of active metabolites of regorafenib, and adverse reactions need to be monitored.

4. Special precautions

(1) Myocardial ischemia/infarction: Patients with a history of coronary heart disease should use it with caution.

(2) Reversible posterior leukoencephalopathy syndrome: If neurological symptoms appear, medication should be stopped immediately.

(3) Delayed wound healing: Discontinue medication at least 2 weeks before scheduled surgery.