Evidence map›Paper›PMID 38987363›Full record

Trial reportCancer chemotherapy and pharmacology2024

Regorafenib plus FOLFIRINOX as first-line treatment for patients with RAS-mutant metastatic colorectal cancer (FOLFIRINOX-R trial): a dose-escalation study.

Antoine Adenis, François Ghiringhelli, Ludovic Gauthier, Thibault Mazard, Ludovic Evesque, Alexandre Evrard, Patrick Chalbos, Aurore Moussion, Sophie Gourgou, Marc Ychou

Registry-linked trialAbstract readClinical Trial, Phase IClinical Trial, Phase II
In one paragraph

Trial report in Cancer chemotherapy and pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03828799 (Safety, Tolerability and Efficacy of Regorafenib in Combination With FOLFIRINOX in Patients With RAS-mutated Metastatic Colorectal Cancer), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03828799 phase1 / phase2completednot on this map

Safety, Tolerability and Efficacy of Regorafenib in Combination With FOLFIRINOX in Patients With RAS-mutated Metastatic Colorectal Cancer: a Dose-escalation, Phase I/II Trial

TypeinterventionalSponsorInstitut du Cancer de Montpellier - Val d'AurelleRan2019 to 2024Enrolled13ConditionsMetastatic Colorectal CancerArmsFolfirinox + regorafenib
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Circular RNAs modulate cancer drug resistance: advances and challenges.Cancer drug resistance (Alhambra, Calif.) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Antoine AdenisMedical Oncology Department, Montpellier Cancer Institute (ICM), INSERM U1194, Montpellier University, Montpellier, 34298, France. antoine.adenis@icm.unicancer.fr.ORCID 0000-0003-3123-9746
François GhiringhelliMedical Oncology Department, Centre Georges-Francois Leclerc, Dijon, France.
Ludovic GauthierBiometrics Unit, Montpellier Cancer Institute (ICM), Montpellier University, Montpellier, France.
Thibault MazardMedical Oncology Department, Montpellier Cancer Institute (ICM), INSERM U1194, Montpellier University, Montpellier, 34298, France.ORCID 0000-0002-5644-9603
Ludovic EvesqueMedical Oncology Department, Centre Antoine Lacassagne, Nice, France.
Alexandre EvrardMontpellier Cancer Research Institute (IRCM), INSERM U1194, Montpellier University, Montpellier, France.
Patrick ChalbosClinical Research and Innovation Department, Montpellier Cancer Institute (ICM), Montpellier University, Montpellier, France.
Aurore MoussionClinical Research and Innovation Department, Montpellier Cancer Institute (ICM), Montpellier University, Montpellier, France.ORCID 0000-0001-8990-314X
Sophie GourgouBiometrics Unit, Montpellier Cancer Institute (ICM), Montpellier University, Montpellier, France.ORCID 0000-0002-6328-9839
Marc YchouMedical Oncology Department, Montpellier Cancer Institute (ICM), INSERM U1194, Montpellier University, Montpellier, 34298, France.ORCID 0000-0001-7378-9469

Funding

Bayer Healthcare Pharmaceuticals N/A
6 · The paper itself

Abstract

purposeThe combination of bevacizumab and FOLFIRINOX is used in patients with RAS-mutant metastatic colorectal cancer (RASm-mCRC). Regorafenib, an oral multi-tyrosine kinase inhibitor, has antiangiogenic properties, cytostatic effects and also true cytotoxic effects, unlike bevacizumab. The aim of this study was to determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of the regorafenib-FOLFIRINOX combination in patients with RASm-mCRC.

methodsThe FOLFIRINOX-R trial was a phase 1/2 study where the dose-escalation part (3 + 3 design with three dose levels, DLs) was completed before its early termination. FOLFIRINOX (14-day cycle) included oxaliplatin (standard dose), folinic acid, fluorouracil and irinotecan (150 or 180 mg/m²). Regorafenib (120 or 160 mg daily) was given from day 4 to day 10 of each cycle. Dose-limiting toxicity (DLT) was studied in the first three cycles. Eligibility criteria included ECOG performance status ≤ 1 and not previously treated RASm-mCRC.

resultsThirteen patients (median age: 65 years; min-max: 40-76) were enrolled. DLT could not be evaluated in one patient (DL3) due to poor observance. The median treatment duration and median follow-up were 6.2 (min-max: 2.3-10) and 13.4 (min-max: 3.8-18.0) months, respectively. Dose was modified in 12/13 (92%) patients. One grade 3 hypokalemia occurred at DL2. MTD was not reached at DL3. Grade 3 diarrhea was recorded in 7/13 patients (13 events) equally distributed in all DLs.

conclusionThe RP2D for this regorafenib-FFX combination could not be determined due to a high prevalence of grade 3 diarrhea related to treatment as advised by our Independent Data Monitoring Committee. TRIAL REGISTRATION NUMBERS: ClinicalTrials.gov : NCT03828799.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsFluorouracilIrinotecanLeucovorinMaximum Tolerated DoseOxaliplatinPhenylurea CompoundsPyridinesAdultAgedDose-Response Relationship, DrugFemaleHumansMaleMiddle AgedFluorouracilfolfirinoxIrinotecanLeucovorinOxaliplatinPhenylurea CompoundsPyridinesregorafenibColorectal cancerFOLFIRINOXPhase 1 trialRecommended phase 2 doseRegorafenib

Identifiers

PMID38987363
PMCPMC11420384

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.