" the Regoranfenib Post & other new drugs"

Lovekitties said:

Misunderstanding
I think there has been a misundertanding...if you read starting at the title of the post and continue to the body, you will see that the post you reference is actually very interested in this drug.

Pamela123 said:

I'm sorry that my
I'm sorry that my descriptions are not the most informative and desivive. I dont think i will continue this post due to lack of interest. The comment about "Who would want to take this drug anyway" kinda made that descision for me. Thank you for the help this site has giving me in my times of need.

steved said:

Have been reading a bit on these lately and thought I would post my interpretation of the data so far:

Regorafenib (Reg, hear forward to save typing)- is a blocker of VEGF receptor so works in the same pathway as Avastin (which binds VEGF A) aiming to interfere with development of new blood vessels in tumours. The big phase III trial described is certainly significant despite the confusing finding it only increased median survival by 1.4 months. The patient group , as described above, were a very late group who had not responded to all other treatments whose life expectancy was very short. It was extended by almost a third by the drug.In this group almost none (1%) 'responded' ie saw tumour shrinkage, but a good number had their disease stabilised- a good outcome in this group. It needs testing on earlier phases with more data on other end points- quality of life beingone of them. They are also investigating subgroups with the feeling there is a likely group of peoplpe who benefit (bit like the KRAS issue with cetuxamab).

Aflibercept- is described as a VEGF trap- it binds VEGF A and B and other factors that promote angiogenesis (blood vessel development). It is therefore being promoted as being able to do more than avastin. It too has a phase III trial (VELOUR) in 1226 patients treated with either FOLFIRI with placebo or FOLFIRI with aflibercept. Again survival was improved by about 1.5 months and progression free survival (stable disease period) was increased by 2.2 months. There was also a higher 'response rate' of 19.8% in the treatment group (11.1% in placebo) which is something the Reg study didn't find (though in different patient groups). The side effect profile does concern me though with Aflibercept with high rates of renal problems and hypertension.It is now being studied with FOLFOX.

Both are very important developments and I think there will be a race to get them approved and find a place in the protocols. They will initially be used late in protocols after others fail but as more studies are done in ealier groups they may move up the algorithms.

I do think people's experiences with these drugs MUST be reported here as they are invaluable to many of us.If people feel discouraged from doing so it is a huge loss to many of us interested in these drugs. They are truly the first big developments since avastin in a field that has been quiet for too long. For many of us they offer hope- that is vital.

steve

peterz54 said:

for mCRC
I just read an article in press for Clinical Colorectal Cancer

Survival Outcomes of Bevacizumab Beyond
Progression in Metastatic Colorectal Cancer
Patients Treated in US Community Oncology - T. Cartwright

it indicates that mCRC patients who have completed their first line therapy and then take Bevacizumab (Avastin) beyond progression have a 6 month advantage in overall survival versus those that did not take Bevacizumab

steved said:

Interesting
Thanks for this- can only find abstracts of the article online- do you have access to the full article {(if so can you put a link or perhaps send it as a PM for me to read through- prefer to make a judgement of the value of the data only after seeing the full article).

If I understand right the suggestion is that if you are on avastin and your cancer progresses you do still do better if you stay on Avastin (6 months longer survival overall, but only 4 onths better if measured from teh point where your cancer is deemed to have still progressed) than if you come off it. This is important as often doctors response to cancer progression on chemo is to stop or change that chemo and in the case of avastin that may not be the best thing. :It suggests, even in progressing cancer blocking VEGF slows the overall rate to death in CRC.

Worth making your docs aware of this if you are in this position but also on a personal level it doesn't address the issues of quality of life on and off avastin- only measures time till death as the end point.

steve