Nicholas Hornstein: No Patient Should Ever Start at 160 mg of Regorafenib
Nicholas Hornstein/X

Nicholas Hornstein: No Patient Should Ever Start at 160 mg of Regorafenib

Nicholas Hornstein, Assistant Professor at Northwell Health, shared a post on LinkedIn:

“Say it with me: no patient should ever start at 160 mg of regorafenib.

New real-world data from ASCO GI 2026 (Abstract 136) back up what many of us already do in clinic.

Italian mCRC cohort comparing three strategies:

  • ReDOS step-up dosing
  • Fixed reduced dosing (<160 mg)
  • Standard upfront dosing (160 mg)

Overall survival favored ReDOS and fixed reduced dosing over full-dose initiation (7.4 vs 8.3 vs 6.1 months). No survival advantage to starting at 160 mg.

Progression-free survival also favored ReDOS versus both comparators.

No excuses anymore, follow ReDOS and improve toxicity without sacrificing efficacy.”

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