Clinical usefulness of ramucirumab plus paclitaxel for unresectable and recurrent gastric cancer

Abstract

Introduction Recently in Japan, Ramucirumab (RAM) became the first antiangiogenic agent to be approved for secondline treatment of gastric cancer. In the present study, we aimed to evaluate the efficacy and safety of RAM plus paclitaxel (PTX) in patients with unresectable and recurrent gastric cancer in our institution. Patients and Methods The subjects were 11 patients with unresectable and recurrent gastric cancer who received RAM plus PTX as a secondor laterline treatment at our hospital between June 2015 and September 2017, after the failure of previouslyattempted treatments. We assessed the efficacy and safety of RAM plus PTX, and also compared them between patients aged <75 years (n=6) and those aged ≥75 (n=5), by performing a retrospective analysis based on the data obtained from daily clinical practice for gastric cancer treatment. Results Objective tumor response was observed in one of the 11 patients (9.1%) with partial response, and disease control was seen in the remaining 10 (90.9%). The median overall survival (OS) and progressionfree survival (PFS) of the patients were 20.8 months (95% CI 7.8-NA (not applicable)) and 11.3 months (95% CI 6.5-NA), respectively. There were no serious adverse events. The median OS for the <75 years group and ≥75 years group was NA (due to short followup period) and 20.8 months (p = 0.336), respectively, and their respective median PFS rates were 9.4 and 11.3 months (p = 0.492). The difference of rate of adverse events was not significant between the two age groups in the present study, though the number of adverse events was not sufficient. Conclusion The results of the present study suggest that the combination chemotherapy of RAM and PTX was effective in unresectable and recurrent gastric cancer patients as a secondor laterline therapy, and has been shown to be safe and feasible in elderly patients.

How May Ramucirumab Help Improve Treatment Outcome for Patients with Gastrointestinal Cancers?

“…In Japan, ramucirumab treatment, as a single agent or in combination with paclitaxel, has been assessed for patients with advanced gastric cancer with or without disease progression after first-line therapy in several real-world clinical practice settings [ 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. Results appear to be consistent with those from the RAINBOW and REGARD trials.…”

“…Results appear to be consistent with those from the RAINBOW and REGARD trials. These studies included patients with large amounts of ascites [ 44 ], in patients categorized as elderly [ 46 , 47 , 49 , 52 ], and in those with liver metastases [ 55 ]. Finally, in Korea, patients enrolled in an expanded access program (EAP) received ramucirumab in combination with paclitaxel or with ramucirumab monotherapy [ 56 ].…”

IL35 predicts prognosis in gastric cancer and is associated with angiogenesis by altering TIMP1, PAI1 and IGFBP1

“…When a tumor exceeds 2 mm 3 , tumor cells can secrete a variety of cytokines to promote angiogenesis [5]. Several studies have also demonstrated that antiangiogenic therapy efficiently prolongs survival in patients with advanced GC [6,7].…”