Регорафениб в лечении метастатического колоректального рака: больше данных для принятия решений

Петкау В.В., Каримова А.А., Акишина З.В. Регорафениб в лечении метастатического колоректального рака: больше данных для принятия решений. Современная Онкология. 2021; 23 (3): 436–441. DOI: 10.26442/18151434.2021.3.201130

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Petkau VV, Karimova AA, Akishina ZV. Regorafenib in metastatic colorectal cancer: more data for clinical decisions. Journal of Modern Oncology. 2021; 23 (3): 436–441. DOI: 10.26442/18151434.2021.3.201130

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Аннотация

Регорафениб – мультитаргетный ингибитор тирозинкиназ, оказывающий влияние на ангиогенез (VEGFR1-3, TIE2), пролиферацию (KIT, RET, RAF-1, BRAF), метастазирование (VEGFR2-3, PDGFR), опухолевую иммуногенность (CSF1R), микроокружение опухоли (PDGFR-α, PDGFR-β, FGFR1-2). Регорафениб зарегистрирован по нескольким показаниям, в том числе для лечения метастатического колоректального рака. В статье представлены и обобщены данные по эффективности и профилю безопасности препарата, полученные как в клинических исследованиях III фазы (CORRECT, CONCUR, CONSIGN), так и в наблюдательных исследованиях в реальной клинической практике (REBECCA, CORRELATE, RECORA, PMS, REGOTAS). Рассмотрено изучение предикторов ответа, как молекулярно-биологических (KRAS, PIK3CA ANG-2, VEGF-A, ЛДГ, CCL5/CCR5, CA 19-9), так и рентгенологических (исследование RadioCORRECT и др.). Представлены варианты дозирования на основании исследований ReDOS, RESET, REARRANGE. Изучены данные ретроспективных исследований по сравнению регорафениба с другим зарегистрированным для рефрактерного метастатического колоректального рака препаратом трифлуридин/типирацил.

Ключевые слова: рефрактерный метастатический колоректальный рак, регорафениб, третья линия

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Regorafenib is a multiple kinase inhibitor. It influences/blocks angiogenesis (VEGFR1-3, TIE2), proliferation (KIT, RET, RAF-1, BRAF), metastatic activity (VEGFR2-3, PDGFR), tumor immunogenicity (CSF1R), tumor microenvironment (PDGFR-α, PDGFR-β, FGFR1-2). Regorafenib has several indications including metastatic colorectal cancer. Efficacy and safety of regorafenib data from clinical trials (CORRECT, CONCUR, CONSIGN) and observational trials from real world (REBECCA, CORRELATE, RECORA, PMS, REGOTAS) are summarized and presented in this issue. State of the matter of molecular-biologic predictors (KRAS, PIK3CA ANG-2, VEGF-A, LDH, CCL5/CCR5, CA 19-9) and radiological predictors (RadioCORRECT and other trials) is highlighted. Regimens with dose modification and its influence on effectiveness and tolerability of regorafenib are described according to the data from ReDOS, RESET, REARRANGE trials. The results from retrospective trials comparing regorafenib and another approved for refractory metastatic colorectal cancer drug trifluridine/tipiracil are presented.

Keywords: refractory metastatic colorectal cancer, regorafenib, third line

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Авторы

В.В. Петкау*1, А.А. Каримова1, З.В. Акишина2

1 ФГБОУ ВО «Уральский государственный медицинский университет» Минздрава России, Екатеринбург, Россия;
2 ГБУЗ Пермского края «Пермский краевой онкологический диспансер», Пермь, Россия
*vpetkau@yandex.ru

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Vladislav V. Petkau*1, Alisa A. Karimova1, Zinaida V. Akishina2

1 Ural State Medical University, Ekaterinburg, Russia;
2 Perm Regional Oncological Dispensary, Perm, Russia
*vpetkau@yandex.ru

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