<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2565-005X</journal-id>
<journal-title><![CDATA[Gaceta mexicana de oncología]]></journal-title>
<abbrev-journal-title><![CDATA[Gac. mex. oncol.]]></abbrev-journal-title>
<issn>2565-005X</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Oncología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2565-005X2021000400127</article-id>
<article-id pub-id-type="doi">10.24875/j.gamo.210000091</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Regorafenib in heavily treated metastatic colorectal cancer: Mexican experience]]></article-title>
<article-title xml:lang="es"><![CDATA[Regorafenib en cáncer colorrectal metastásico muy tratado: experiencia mexicana]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Calderillo-Ruíz]]></surname>
<given-names><![CDATA[Germán]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torrecillas-Torres]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz-García]]></surname>
<given-names><![CDATA[Erika]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pimentel-Rentería]]></surname>
<given-names><![CDATA[Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Hernández]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suárez-Sahui]]></surname>
<given-names><![CDATA[Tirzo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Enríquez-Aceves]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campos-Gómez]]></surname>
<given-names><![CDATA[Saúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera]]></surname>
<given-names><![CDATA[Marytere]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dip]]></surname>
<given-names><![CDATA[Karim]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Romero]]></surname>
<given-names><![CDATA[Consuelo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Cancerología Department of Medical Oncolog ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Centro Médico Nacional 20 de Noviembre Department of Medical Oncology]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Department of Medical Oncology]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Centro Oncológico Privado Department of Medical Oncology ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional Presidente Juárez Department of Medical Oncology]]></institution>
<addr-line><![CDATA[Oaxaca ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional Mérida Department of Medical Oncology]]></institution>
<addr-line><![CDATA[Mérida Yucatán]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado León Regional Hospital ]]></institution>
<addr-line><![CDATA[ Guanajuato]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Instituto de Seguridad Social del Estado de México y Municipios Centro Oncológico Estatal Department of Medical Oncology]]></institution>
<addr-line><![CDATA[Toluca State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>20</volume>
<numero>4</numero>
<fpage>127</fpage>
<lpage>133</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2565-005X2021000400127&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2565-005X2021000400127&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2565-005X2021000400127&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: First and second line standard treatment in patients with metastatic colorectal cancer (mCRC) is with chemotherapy +/- some monoclonal antibody according to the RAS biomarker report. About 30-40% of them will require a third line of therapy, where regorafenib has been approved due to overall and progression-free survival positive results.  Objective: The objective of the study was to describe the Mexican experience with the use of regorafenib in patients with mCRC.  Methods: This was a multi-center, retrospective study where medical records of heavily treatment-experienced mCRC-diagnosed patients who had received at least one cycle of regorafenib were reviewed. Descriptive and inferential statistics were performed, with the Kaplan–Meier method being used for survival calculation using the SPSS v. 23 software.  Results: Forty-five patients with metastatic colorectal adenocarcinoma were included in the study; 18 were females and 27 males, with a mean age of 51 (± 10.3) years. There was previous history of diabetes mellitus in nine cases and arterial hypertension in four, with an ECOG 1 performance status being found in all patients. Primary tumor sites were the colon (23 patients) and rectum (22). KRAS oncogene determination was obtained in 35 patients, out of which 16 were wild-type (46%). All patients had been previously treated with chemotherapy ± monoclonal antibodies, radical surgery, and radiotherapy (where indicated). Primary metastatic sites were: the liver (24 cases), lung (21), retroperitoneum (10), and peritoneum (7). Mean number of regorafenib cycles was 4 (1-13), with initial doses being 160 mg (20 patients), 120 mg (18), and 80 mg (7), with one daily take for 3 weeks and 1-week rest. In 28 patients, regorafenib was started 18 months after metastatic disease diagnosis. Treatment response was partial in four cases (9%), stable disease in 21 (47%), progressive disease in 15 (33%), and not evaluable in five patients. Median survival for the entire group was 6.0 months (1-16 months). Main identified grade 3-4 toxicities were hand-foot syndrome, fatigue, skin dryness, stomatitis, and diarrhea.  Discussion and Conclusions: Regorafenib overall survival benefit in heavily treated mCRC in the Mexican population is confirmed and correlates with the 2 Phase II trials CORRECT and CONCUR, with manageable toxicity. In the population with an interval &gt; 18 months since metastasis onset at regorafenib start, with an ECOG 0-1 and no monoclonal antibodies previous use, regorafenib was correlated with higher survival.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: El tratamiento convencional en 1ª y 2ª línea en pacientes con CCRm es con quimioterapia ± algún anticuerpo monoclonal de acuerdo al reporte de los biomarcadores RAS. Entre un 30-40% de ellos requerirán de una terapia de tercera línea, donde el Regorafenib ha sido aceptado por los resultados positivos en supervivencia global y libre de progresión.  Objetivo: Presentar la experiencia mexicana con el uso de Regorafenib en pacientes con CCRm.  Método: Es un estudio, multicéntrico y retrospectivo. A través de revisión de expedientes clínicos de pacientes con diagnóstico de CCRm multitratados que hayan recibido al menos un ciclo de Regorafenib. Se realizó estadística descriptiva, inferencial, Kaplan-Meier para el cálculo de supervivencia utilizando el SPSS v.23.  Resultados: Se incluyeron 45 pacientes con adenocarcinoma de CCRm, fueron 18 mujeres y 27 hombres, con edad media de 51 (± 10.3) años. Antecedente de diabetes (4 casos) e hipertensión-arterial (8 casos), con un nivel de actividad por ECOG de 1 en todos los pacientes. El sitio del tumor primario: colon (23 pacientes) y recto (22). La Determinación del Oncogen Kras se obtuvo en 35 pacientes, de los cuales 16 fueron wild-type (46%). Todos los pacientes fueron multitratados con quimioterapia ± anticuerpo monoclonal, cirugía radical y radioterapia (si estaba indicado). Los principales sitios de metástasis fueron: Hígado (24 casos), pulmón (21), retroperitoneo (10) y peritoneo (7). La media de número de ciclos de Regorafenib fue de 4 (1-13). Dosis inicial fue a 160mg (20 pacientes), 120 mg (18) y 80mg (7), una toma diaria por 3 semanas con una semana de descanso. En 28 pacientes el regorafenib se inició 18 meses después del diagnóstico de la enfermedad metastásica. La respuesta al tratamiento fue parcial en 4 casos (9%), estable en 21 (47%), progresión en 15 (33%) y no valorable en 5 pacientes. La mediana en supervivencia de todo el grupo fue de 6.0 meses (1-16 meses). Las principales toxicidades grado 3-4 identificadas fueron el síndrome mano pie, fatiga, sequedad de piel, estomatitis y diarrea.  Discusión y Conclusiones: El beneficio en supervivencia global de Regorafenib en CCRm multitratados en población mexicana se confirma y se correlaciona con los dos estudios de fase III CORRECT y CONCUR con toxicidad manejable. En población con un intervalo &gt;18 meses desde la metástasis al inicio de Regorafenib, con un ECOG 0-1 y la no utilización de anticuerpos monoclonales previos se correlacionó con una mayor supervivencia.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Treatment]]></kwd>
<kwd lng="en"><![CDATA[Metastasis]]></kwd>
<kwd lng="en"><![CDATA[RAS biomarker]]></kwd>
<kwd lng="es"><![CDATA[Tratamiento]]></kwd>
<kwd lng="es"><![CDATA[Metástasis]]></kwd>
<kwd lng="es"><![CDATA[Biomarcadores RAS]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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