How to prevent and manage hypertension during treatment with regorafenib?

Regorafenib is a multi-target tyrosine kinase inhibitor commonly used to treat malignant tumors such as colorectal cancer, gastrointestinal stromal tumors and hepatocellular carcinoma. During the treatment process, hypertension is one of the more common adverse reactions, which mostly occurs in the early stages of treatment. Because regorafenib affects vascular endothelial function by inhibiting the VEGF pathway, causing vasoconstriction and increased resistance, thereby causing an increase in blood pressure, the prevention and management of hypertension is particularly important to ensure the safety of treatment.

Before medication, it is recommended to conduct a detailed baseline blood pressure assessment on the patient to ensure that blood pressure is well controlled before initiating treatment. If the patient has essential hypertension, the antihypertensive plan should be optimized before initiating regorafenib treatment and strive to control the blood pressure below 140/90mmHg. In addition, for older patients with a history of cardiovascular disease, doctors should provide more stringent monitoring and evaluation to reduce the risk of hypertension-related complications.

During treatment, blood pressure should be monitored regularly every week, especially in the first few weeks of medication. Once blood pressure is found to be elevated, timely measures should be taken to adjust it. For example, calcium channel blockers, ACEI or ARB drugs can be used first for antihypertensive treatment. These drugs have good efficacy against the vasotensing effect caused by regorafenib. If the blood pressure persists, consider temporarily reducing the dose or stopping the medication, and then evaluate whether to resume treatment after the blood pressure stabilizes.

In short, the management of regorafenib-related hypertension emphasizes“prevention first, timely monitoring, and reasonable intervention.” Only by continuing treatment within a safe blood pressure range can the anti-tumor efficacy of regorafenib be maximized and cardiovascular risks reduced. Therefore, patients should follow the doctor's advice to regularly check their blood pressure during medication, and maintain good communication with the doctor to ensure the safety and continuity of treatment.

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