{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:14:45Z","timestamp":1784268885750,"version":"3.55.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Regorafenib at different dosing strategies and TAS-102 are treatment options for refractory metastatic colorectal cancer (mCRC). We aimed to evaluate the comparative effectiveness evidence supporting these different strategies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We searched different databases for randomized controlled trials evaluating TAS-102 or regorafenib in patients with refractory mCRC who failed prior oxaliplatin, irinotecan, and fluoropyrimidine. Outcomes of interest included overall survival (OS) and progression-free survival (PFS). The overall effect was pooled using the DerSimonian random effects model. We conducted network meta-analysis based on White's multivariate meta-regression to pool evidence from direct and indirect comparisons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Six trials at low risk of bias (2,445 patients) were included. Direct comparisons showed that Rego 160 and TAS-102 as monotherapy were superior to best-supportive care (BSC) in terms of PFS (Rego 160: hazard ratio [HR], 0.4; 95% confidence ratio [CI], 0.26\u20130.63; TAS-102: HR, 0.46 CI, 0.40\u20130.52) and OS (Rego 160: HR, 0.67; CI, 0.48\u20130.93; TAS-102: HR, 0.67; CI, 0.57\u20130.80). Network analysis showed no statistically difference in PFS or OS between Rego 160 and TAS-102. Rego 80+ was superior to BSC in terms of OS (HR, 0.44; CI, 0.23\u20130.84) and PFS (HR, 0.37; CI, 0.21\u20130.66). Rego 80+ was associated with statistically nonsignificant improvement in OS and PFS compared with TAS-102 and Rego 160.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Regorafenib 160 and TAS-102 appear to have similar efficacy. Rego 80+ is shown to be superior to BSC. A trend for improved OS was observed with Rego 80+ versus Rego 160 or TAS 102.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications for Practice<\/jats:title>\n                  <jats:p>Regorafenib at a dose of 160 mg and TAS-102 appear to have similar efficacy in patients with refractory metastatic colorectal cancer. Regorafenib with a dose escalation strategy is superior to best-supportive care. Given its tolerability and the observed trend in survival benefit compared with regorafenib 160, dose escalation strategy of regorafenib (80+) may be the preferred option in this setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1634\/theoncologist.2019-0189","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T20:35:29Z","timestamp":1559680529000},"page":"1174-1179","source":"Crossref","is-referenced-by-count":21,"title":["A Systematic Review and Network Meta-Analysis of Regorafenib and TAS-102 in Refractory Metastatic Colorectal Cancer"],"prefix":"10.1093","volume":"24","author":[{"given":"Mohamad Bassam","family":"Sonbol","sequence":"first","affiliation":[{"name":"Mayo Clinic Cancer Center, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed","family":"Benkhadra","sequence":"additional","affiliation":[{"name":"Allegheny General Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belal","family":"Firwana","sequence":"additional","affiliation":[{"name":"Heartland Cancer Research NCORP, Missouri Baptist Medical Center, St Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Walden","sequence":"additional","affiliation":[{"name":"Mayo Clinic Cancer Center, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kabir","family":"Mody","sequence":"additional","affiliation":[{"name":"Mayo Clinic Cancer Center, Mayo Clinic, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joleen M.","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Mayo Clinic Cancer Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Mayo Clinic Cancer Center, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanios","family":"Bekaii-Saab","sequence":"additional","affiliation":[{"name":"Mayo Clinic Cancer Center, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"issue":"suppl 4","key":"2021122507525982700_onco12991-bib-0001","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/annonc\/mdp130","article-title":"ESMO Guidelines Working Group. 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