{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T08:56:04Z","timestamp":1763715364173,"version":"3.45.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aims to compare the effectiveness and safety of standard and reduced initial doses of regorafenib in patients with metastatic colorectal cancer (mCRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective observational study was conducted using the Taipei Medical University Clinical Research Database. Patients aged 20\u2009years or older who received regorafenib for mCRC between January 2014 and December 2021 were included. Patients were divided into standard initial dose (160\u2009mg) and reduced initial dose (&lt;\u2009160\u2009mg) groups. Time\u2010to\u2010treatment discontinuation (TTD), overall survival (OS), and the incidence of five common adverse events were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 266 patients, 58 received the standard initial dose and 208 received the reduced initial dose; the median TTD was 68.0\u2009days and 64.5\u2009days, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.25). The median OS was 9.7\u2009months for the standard\u2010dose group and 6.7\u2009months for the reduced\u2010dose group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). In the multivariate Cox analysis, the reduced initial dose was associated with shorter survival (hazard ratio 1.66 [95% confidence interval 1.22\u20132.30]). Hand\u2010foot skin reaction and total bilirubin elevation were less common in the reduced\u2010dose group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01 and 0.03, respectively). Excluding concurrent anti\u2010cancer drug users led to a similar median OS between the two dosing groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.12).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No difference in TTD was observed between the dosing groups. The reduced\u2010dose group had a shorter OS but fewer adverse events. For patients who can tolerate standard doses of regorafenib, a combination of regorafenib and other anti\u2010cancer drugs may be beneficial but would require further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70221","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:22:38Z","timestamp":1761808958000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and Safety of Reduced and Standard Initial Doses of Regorafenib in Patients With Metastatic Colorectal Cancer: A Multicenter Retrospective Study in Taiwan"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8251-5125","authenticated-orcid":false,"given":"Yu\u2010Hsuan","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-4400","authenticated-orcid":false,"given":"Chun\u2010Nan","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy Taipei Medical University  Taipei Taiwan"},{"name":"Department of Pharmacy Wan Fang Hospital, Taipei Medical University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5280-7733","authenticated-orcid":false,"given":"Chia\u2010Lun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Hemato\u2010Oncology Wan Fang Hospital, Taipei Medical University  Taipei Taiwan"},{"name":"Department of Internal Medicine, School of Medicine, College of Medicine Taipei Medical University  Taipei 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