OBJECTIVES: To describes treatment patterns among patients initiating regorafenib, an oral kinase inhibitor indicated for the treatment of metastatic colorectal cancer in patients who have tried other first-line therapies. METHODS: Pharmacy and medical claims from Humana, a large national U.S. payer, were used.  The study sample included patients age 19 to 89 years with at least one claim for regorafenib between 9-27-2012 and 6-1-2013. A subset of patients with pharmacy and medical benefits, as well as pre-index continuous enrollment of at least 12 months, was used to examine prior exposure to chemotherapy, radiation, and biologic therapies.  Patients were followed until death, disenrollment or study end date (10-31-2013).  RESULTS: A total of 407 patients with claims for regorafenib were identified. The mean age was 66.4 years, 53.1% were male, and median length of follow up was 140 days (range of 0-357 days).  Median length of pre-index continuous enrollment was 779 days.  The majority resided in the southern (51.6%) and midwestern (26.0%) U.S. and most patients had Medicare Advantage (26.0%) or Medicare Part D (69.3%) coverage.  A total of 91 regorafenib patients met all inclusion/exclusion criteria.  Metastatic cancer diagnosis was observed in 93.4% of patients; the majority had liver metastases.  Common pre-index comorbidities included hypertension (72.5%), fluid/electrolyte disorders (41.8%), chronic pulmonary diseases (25.3%), diabetes (34.1%), and depression (15.4%).  Evidence of chemotherapy, biologic therapy, and surgery at any time during the study period was present in 94.5%, 91.2%, and 65.9% of patients, respectively (5.5% of patients had no claims indicating any prior cancer treatment).  Mean length of chemotherapy treatment was 806 days, and 571 days for biologic treatment. CONCLUSIONS: Patients initiated on regorafenib were largely suffering from metastatic cancer, and had a range of comorbid conditions.  Nearly all patients were treated with chemotherapy and/or biologic agents before initiating regorafenib treatment.