Personalized regorafenib schedules lead to significant improvements in therapeutic outcomes in patients with metastatic gastrointestinal stromal tumors (GISTs), finds a study published in the journal of the European Society for Medical Oncology. Therefore, treatment optimization for each patient with GIST may represent the best strategy to maximize long-term therapy. 

Research has proven that third-line treatment with regorafenib is efficient in treating GISTs. However, patients may not tolerate the treatment well. This can lead to transient or permanent treatment discontinuation or require clinicians to modify their patients’ treatment.

In order to investigate the safety and efficacy of personalized schedules of regorafenib in metastatic GIST patients, and compare this to the standard schedule, which is 160 mg of regorafenib every day for 3 weeks followed by no treatment for 1 week, a team of researchers from Italy retrospectively reviewed institutional registries across 7 Italian reference centers.

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Predicting Prognosis in Patients With GIST

This way, they identified 152 patients with GIST who were treated with regorafenib between February 2013 and January 2021. Of these, 49 were treated with a standard schedule and 103 with personalized schedules. The results showed that at a median follow-up of 36.5 months, median progression-free survival was 5.6 months in patients treated with the standard schedule compared to 9.7 months in patients who received a personalized treatment schedule. 

The median overall survival was 16.6 months in patients receiving the standard regorafenib treatment schedule, while it was 20.5 months in patients receiving a personalized schedule. 

These differences in progression-free survival and overall survival are statistically significant.

“A prompt personalization of regorafenib could help clinicians avoid early treatment discontinuation due to adverse events,” the researchers reported. They added that based on these findings, a patient-tailored approach could also benefit patients with other types of metastatic solid tumors who are treated with regorafenib.


Nannini M, Rizzo A, Nigro MC, et al. Standard versus personalized schedule of regorafenib in metastatic gastrointestinal stromal tumors: a retrospective, multicenter, real-world study. ESMO Open. Published online August 2, 2021. doi:10.1016/j.esmoop.2021.100222