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An Observational Study, Called RegoFlex EU, to Learn More About the Use of Stivarga at Reduced Doses as Recommended (Flexible Dosing) to Treat People With Metastatic Colorectal Cancer in Real World Settings in Europe

Completed
Conditions
Metastatic Colorectal Cancer
Interventions
Other: Retrospective patient chart review
Registration Number
NCT05551039
Lead Sponsor
Bayer
Brief Summary

This is an observational study in which data from patients with metastatic colorectal cancer in three European countries who received STIVARGA® (regorafenib), are collected. In observational studies, only observations are made without specified advice or interventions.

Metastatic colorectal cancer (mCRC) is a cancer that starts in the large bowel or the rectum (the lowest part of the gut) and has spread to other parts of the body. Regorafenib is an anti-cancer drug that blocks several proteins called enzymes, which are involved in the development and growth of cancer. A wide range of such enzymes called tyrosine kinases are targeted.

In 2013, regorafenib was approved in Europe for doctors to prescribe to people with mCRC who have previously been treated or cannot receive other available treatments. It is known that doctors may change/reduce the amount (the dose) of regorafenib they give (flexible dosing), so that the patients better tolerate the treatment. However, little information is available on the doses of regorafenib given in France, Italy, and Belgium in usual practice.

In this study researchers want to learn more about how and in which amount regorafenib is usually given to patients with mCRC in France, Italy, and Belgium:

* at the beginning

* during, and

* at the end of the regorafenib therapy.

In addition, the study team will collect data about/if:

* the treatment duration at each treatment dose of regorafenib,

* the number of people who received reduced initial dosing of regorafenib in real word settings in France, Italy, and Belgium,

* reduced (flexible) initial dosing of regorafenib allows patients to stay longer on treatment.

To answer these questions, the researchers will look back at cases that have already happened when the study begins. The data will be collected through an online case report form. The doctors will provide case histories of mCRC patients who started regorafenib treatment in most recent 3 years and 4 months (from January 1, 2019 to Apr 30, 2022) or up until 3 months prior to the date of data collection.

Besides this data collection, no further tests or examinations are planned in this study.

There are no required visits or tests in this study.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
300
Inclusion Criteria
  • Patients with a histopathological or cytological diagnosis of colorectal cancer and metastatic disease (stages IVA, IVB, or IVC)
  • Patients must have initiated regorafenib as monotherapy, regardless of line of therapy, from January 1, 2019 to December 31, 2021 (or up until 3 months prior to date of data collection, whichever occurs latest)
  • Aged ≥18 years at index date
Exclusion Criteria
  • Patients with regorafenib treatment prior to January 1, 2019
  • Patients who have participated in a clinical trial

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Physicians treating patients with mCRCRetrospective patient chart reviewPhysicians provide case histories of mCRC patients
Primary Outcome Measures
NameTimeMethod
Dose at treatment end (last prescribed regorafenib dose): 40, 80, 120, or 160 mgRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)
Average dose intensity at first and subsequent cyclesRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

The sum of dose strength (mg) will be divided by the days on therapy in each cycle.

Duration of treatment (DoT)Retrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Duration of treatment: time (months) from date of initial regorafenib dose to date of last dose prior to a \>2-week gap during the follow up period.

Time to discontinuation (TTD)Retrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Time to discontinuation: time (months) from date of initial regorafenib dose to date of discontinuation (as indicated by CRF)

Proportion of patients initiating a flexible regorafenib dose (40, 80, or 120 mg) versus 160 mgRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)
Time to first dose changeRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Time to first dose change: time (months) from date of initial regorafenib dose to 1st dose increase/decrease among patients initiating a flexible regorafenib dose (40, 80, or 120 mg)

Time to first full dose of 160 mgRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Time to 1st full dose of 160 mg: time (months) from date of initial regorafenib dose to 1st full dose of 160 mg during the treatment history among patients with 40, 80, or 120 mg initial dose, overall and by initial dose.

Number of cycles receivedRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)
Proportion of patients initiating 1, 2, 3, or more cyclesRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

The label recommended regorafenib treatment cycle is 28 days.

Proportion of patients with reasons for discontinuationRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Reasons for discontinuation includes: distant progression/relapse, local progression/relapse, patient choice to discontinue therapy, poor performance status, side effects, new primary malignancy, death, lost to follow up, coronavirus disease 2019 (COVID-19)-related and other.

Secondary Outcome Measures
NameTimeMethod
Descriptive summary of demographics characteristicsRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Demographic characteristics includes: age, sex, index year (calendar year of regorafenib treatment initiation date), race, alive or deceased at time of data collection, primary cause of death (for deceased patients only).

Descriptive summary of K-RAS mutation status and N-RAS mutation statusRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

K-RAS mutation status and N-RAS mutation status includes: Wild type, Mutated and Unknown.

Descriptive summary of Line of therapy (LOT) for regorafenibRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Line of therapy (LOT) for regorafenib includes: 2nd, 3rd, 4th and 5th or higher.

Descriptive summary of Pre-existing comorbiditiesRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Pre-existing comorbidities: Asthma, Atrial fibrillation, Auto-immune disease, Cardiac dysfunction, Chronic obstructive pulmonary disease, COVID-19, Diabetes, Hepatitis C, AIDS/HIV, Human papillomavirus, Liver dysfunction, Parkinson's, Peripheral neuropathy, Renal dysfunction, Thrombocytopenia, Venous thromboembolism, Other and None.

Descriptive summary of Stage of diseaseRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Stage of disease includes: Stage IVA; Stage IVB and Stage IVC

Descriptive summary of Primary tumor statusRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Primary tumor status includes: Local recurrence; Resected and Unresected

Descriptive summary of Number of metastaticRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Number of metastatic includes: 1, 2 and ≥3

Descriptive summary of Site of metastasisRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Site of metastasis includes: Bone, Liver, Lung, Lymph node, Peritoneum and Other.

Descriptive summary of Eastern Cooperative Oncology Group (ECOG) performance statusRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

ECOG scale scores are: 0, 1, 2, 3, 4 and Unknow. The higher score means worse performance status.

Descriptive summary of Prior adjuvant treatmentRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Prior adjuvant treatment includes: No and Yes.

Descriptive summary of Treatments prior to index date, overall and by LOTRetrospective analysis from 01-Jan-2019 up to 30-Apr-2022 (or up until 3 months prior to date of data collection, whichever occurs latest)

Treatments includes: Fluorouracil, Capecitabine, Irinotecan, Leucovorin, Mitomycin, Oxaliplatin, Anti-EGFR monoclonal antibody snf Anti-VEGF monoclonal antibody.

Trial Locations

Locations (1)

Many locations

🇺🇸

Whippany, New Jersey, United States

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