Adverse event management strategies: optimizing treatment with regorafenib in patients with metastatic colorectal cancer

Clin J Oncol Nurs. 2014 Apr;18(2):E19-25. doi: 10.1188/14.CJON.E19-E25.

Abstract

Patients with metastatic colorectal cancer (mCRC) frequently experience treatment-related adverse events (AEs), which may lead to nonadherence or discontinuation from their treatment regimen. In the phase 3 CORRECT study, the addition of regorafenib to best supportive care (BSC) significantly increased overall survival and progression-free survival compared with placebo plus BSC in patients with mCRC who had progressed on all approved standard care therapies. Although regorafenib showed an acceptable safety profile, patients experienced treatment-related AEs such as hand-foot skin reaction, hypertension, oral mucositis, diarrhea, fatigue, and liver abnormalities. The goal of this article is to help oncology nurses implement a strategic, proactive approach to AE management in patients mCRC treated with regorafenib. The article reviews the most common AEs associated with regorafenib in patients who participated in the CORRECT study and provides a strategy and practical measures that nurses can apply to AE management. In addition, the article provides direction and guidance for educating patients and their caregivers on recognizing and managing potential side effects of regorafenib.

Keywords: biotherapy/targeted therapy; gastrointestinal malignancies.

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Diarrhea / chemically induced
  • Fatigue / chemically induced
  • Humans
  • Hypertension / chemically induced
  • Hypertension / drug therapy
  • Liver / drug effects
  • Liver / physiopathology
  • Neoplasm Metastasis
  • Phenylurea Compounds / adverse effects*
  • Phenylurea Compounds / therapeutic use
  • Pyridines / adverse effects*
  • Pyridines / therapeutic use
  • Stomatitis / chemically induced

Substances

  • Antineoplastic Agents
  • Phenylurea Compounds
  • Pyridines
  • regorafenib