Regorafenib-induced retinal and gastrointestinal hemorrhage in a metastatic colorectal cancer patient with liver dysfunction: A case report.

Medicine (Baltimore)

Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University Department of Medical Oncology, National Hospital Organization Kyushu Medical Center Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka Department of Medical Oncology, Sasebo Kyosai Hospital, Sasebo Department of Medical Oncology, Fukuoka Wajiro Hospital Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

Published: October 2017

Rationale: Regorafenib is effective for metastatic colorectal cancer but its toxicity such as hemorrhage should be considered. The safety of regorafenib for the patient with the liver disease is not known.

Patient Concerns: Seventy-one-year old man of colon cancer had myodesopsia and blood stool after 14 days from the initiation of regorafenib administration with 50% dose reduction due to liver dysfunction.

Diagnoses: Fundus examination revealed hemorrhage of the retinal vein.

Interventions: Regorafenib treatment was discontinued and observational therapy was pursued.

Outcomes: Retinal and gastrointestinal hemorrhage resolved in 1 week.

Lessons: Retinal hemorrhage should be considered as the differential diagnosis of myodesopsia in the patient treated by regorafenib. Safety and pharmacokinetic of continuous regorafenib administration for patients with liver dysfunction remains to be clarified.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662392PMC
http://dx.doi.org/10.1097/MD.0000000000008285DOI Listing

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