Colorectal cancer

Early MRI imaging predicts regorafenib response

Regorafenib, a multikinase inhibitor with anti-angiogenic activity, shows efficacy in patients with treatment-refractory metastatic colorectal cancer (mCRC). However, modest efficacy in an unselected patient population indicates that better predictive biomarkers of response to regorafenib are needed for appropriate patient selection. In a prospective phase II study of patients (n = 27) with mutant RAS mCRC, Khan et al. found that early (day 15 after treatment) imaging with dynamic contrast-enhanced (DCE) MRI, to establish changes in tumour volume, predicted response and long-term outcomes to regorafenib therapy. Reduced tumour vasculature after treatment was confirmed using tissue biopsies and was associated with a marked reduction in circulating tumour DNA (ctDNA) that, if sustained for 8 weeks, led to even better patient outcomes. Thus, combining DCE-MRI with ctDNA as biomarkers of response to regorafenib might improve patient selection.


  1. 1

    Khan, K. et al. Functional imaging and circulating biomarkers of response to regorafenib in treatment-refractory metastatic colorectal cancer patients in a prospective phase II study. Gut (2017)

Download references


Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Dickson, I. Early MRI imaging predicts regorafenib response. Nat Rev Gastroenterol Hepatol 14, 566 (2017).

Download citation


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing