In a retrospective evaluation of real-world metastatic colorectal cancer treatment, patients with an elevated baseline modified Glasgow Prognostic Score experienced significantly shorter progression-free survival and overall survival when initiating regorafenib monotherapy under a dose-reduction strategy compared with patients who had a baseline score of zero.

Regorafenib functions as the first multikinase inhibitor approved for late-line therapy in metastatic colorectal cancer, where clinical administration frequently employs an initial dose-reduction strategy accompanied by weekly dose escalation tailored to individual patient toxicity profiles. The modified Glasgow Prognostic Score is determined through laboratory measurements of C-reactive protein and serum albumin concentrations, serving as an objective marker that reflects clinical stages of cancer cachexia.

To evaluate the impact of baseline inflammation and nutritional status on therapeutic efficacy and safety, investigators conducted a retrospective cohort analysis encompassing 70 patients diagnosed with metastatic colorectal cancer who initiated regorafenib monotherapy at starting doses between 80 and 120 mg per day. The study population was stratified into two distinct comparative groups, separating a control cohort of patients exhibiting an mGPS of 0 from a high-mGPS cohort presenting scores of 1 or 2, with progression-free survival designated as the primary study endpoint.

The analysis revealed that median progression-free survival was significantly shorter among patients in the high-mGPS group at 49 days, with a 95 percent confidence interval spanning 35 to 56 days, compared with a median of 63 days and a 95 percent confidence interval of 51 to 114 days in the control group (P = 0.0007). In addition to progression-free intervals, overall survival was significantly shorter among individuals within the high-mGPS cohort compared to the control group (P < 0.0001).

Tumor response assessments demonstrated that the disease control rate was significantly lower in the high-mGPS group relative to the control group (P = 0.02). Safety profiles also exhibited distinct patterns between cohorts: while the incidence of severe adverse events showed no significant difference between groups, all-grade hand–foot skin reactions occurred significantly less frequently, and all-grade fatigue occurred significantly more frequently, in the high-mGPS group than in the control cohort.

Secondary stratified analyses further indicated that adverse prognostic effects scaled with higher inflammatory scores, demonstrating significantly shorter progression-free survival and overall survival among patients presenting with an mGPS of 2 compared to those with an mGPS of 1. Based on these observed clinical outcomes across the 70-patient cohort, the researchers concluded that a high baseline modified Glasgow Prognostic Score is closely associated with poor prognosis during real-world reduced-dose initiation of regorafenib for metastatic colorectal cancer.

Subject of Research: Prognostic impact of baseline modified Glasgow Prognostic Score in reduced-dose regorafenib treatment for metastatic colorectal cancer

Article Title: Impact of high modified Glasgow Prognostic Score on regorafenib treatment in real-world metastatic colorectal cancer treatment

Article References: Saito, Y., Takekuma, Y., Komatsu, Y., & Sugawara, M. (2026). Impact of high modified Glasgow Prognostic Score on regorafenib treatment in real-world metastatic colorectal cancer treatment. Discover Oncology. https://doi.org/10.1007/s12672-026-06220-5

Image Credits: AI Generated

DOI: 10.1007/s12672-026-06220-5

Keywords: metastatic colorectal cancer, regorafenib, modified Glasgow Prognostic Score, mGPS, progression-free survival, overall survival, disease control rate, cancer cachexia, C-reactive protein, serum albumin, multikinase inhibitor, dose-reduction strategy, hand-foot skin reaction, fatigue, late-line treatment, oncology, real-world study