# GRID: regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib

Source: https://onco.cc/key-papers/paper-grid-regorafenib-gist-lancet-2013/  
OnCo record `paper-grid-regorafenib-gist-lancet-2013` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Regorafenib delayed progression by almost four months compared with placebo in gastrointestinal stromal tumours resistant to both imatinib and sunitinib, giving patients a third line of targeted therapy.

## Summary

Phase 3 placebo-controlled trial of 199 patients with metastatic or unresectable GIST after failure of imatinib and sunitinib randomised 2:1 to regorafenib 160 mg daily (three weeks on, one off) or placebo with crossover at progression.

Median progression-free survival was 4.8 versus 0.9 months (hazard ratio 0.27) with disease control in 53 versus 9 percent; hypertension, hand-foot skin reaction and diarrhoea were the main toxicities.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2013
- DOI: 10.1016/S0140-6736(12)61857-1
- Authors: Demetri GD, Reichardt P, Kang YK, et al.
- Findings: Median progression-free survival 4.8 vs 0.9 months; hazard ratio 0.27.; Disease control rate 52.6 percent vs 9.1 percent.
- What it means: Regorafenib is the standard third-line treatment for GIST after imatinib and sunitinib.
- Caveats: No overall survival benefit because of crossover.; Dose reductions needed in most patients.

## Sources

- Lancet 2013: https://doi.org/10.1016/S0140-6736(12)61857-1
- PubMed: https://pubmed.ncbi.nlm.nih.gov/23177515/

## Connected records

- cancers: [Imatinib-resistant GIST](https://onco.cc/cancers/gist-imatinib-resistant/)
- drugs: [Imatinib](https://onco.cc/drugs/imatinib/), [Regorafenib](https://onco.cc/drugs/regorafenib/), [Sunitinib](https://onco.cc/drugs/sunitinib/)
- trials: [GRID](https://onco.cc/trials/grid/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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