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(A-C) Chest computed tomography images prior to treatment with regorafenib demonstrating presence of multiple metastases in the lungs (arrows). Longest diameter, 36 mm (June 2013).
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A computed tomography (CT) scan of the chest revealed several large masses in the lungs (longest diameter, 36 mm; Fig. 1A-C) and the patient commenced regorafenib 160 mg/day.
(A-C) The multiple metastatic tumor lesions (arrows) decreased in size and demonstrated characteristic tumor cavitation following two cycles of regorafenib (160 mg/day) (August 2013).
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Following the first two cycles, a notable response was demonstrated on CT, with shrinkage and characteristic cavitation being visible in all metastatic deposits (Fig. 2A-C).
(A-C) The multiple metastatic tumor lesions (arrows) continued to shrink but now represent progressive disease as the cavitation is no longer present (January 2014).
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After the patient had received eight cycles, the metastatic lesions had enlarged by 27% and the cavities had disappeared through filling-in, resulting in an evaluation of PD (Fig. 3A-C).