The Impact of Regorafenib on Cardiac Function in Metastatic Colorectal Cancer Patients a Retrospective Cohort Study

Abstract

Introduction: Metastatic colorectal cancer (mCRC) poses significant clinical challenges, necessitating the exploration of novel treatment modalities. Regorafenib, a multi-kinase inhibitor, has emerged as a promising therapeutic option for refractory mCRC. However, concerns regarding its potential cardiotoxic effects warrant comprehensive evaluation of its impact on cardiac function parameters in this patient population. Methods: The purpose of this retrospective cohort research was to find out how regorafenib affected cardiac function measures in patients with metastatic colorectal cancer (mCRC) at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad. 78 adult patients in all, having histologically proven mCRC, who were treated with regorafenib between January 2023 and March 2024 were included in the analysis. Baseline characteristics, treatment details, cardiac function parameters, and incidence of cardiac events were retrospectively analyzed. Statistical analyses were performed to assess changes in cardiac function parameters and identify predictors of cardiac toxicity associated with regorafenib therapy. Results: Following regorafenib therapy, there was a significant decrease in left ventricular ejection fraction (LVEF), alterations in diastolic function indices, and an incidence of clinically significant cardiac events (12%), including heart failure, arrhythmias, and myocardial infarction. Subgroup analyses identified older age, male sex, pre-existing hypertension, longer treatment duration, and higher cumulative doses of regorafenib as potential predictors of cardiac toxicity. Conclusion: This study underscores the potential cardiotoxic effects of regorafenib in mCRC patients and highlights the importance of personalized cardiac monitoring and risk management strategies during treatment. Further research is warranted to validate these findings and inform evidence-based approaches to optimize the cardiovascular safety of regorafenib in clinical practice.