1418P Chronological improvement in the survival of advanced gastric cancer patients in the past 15 years

Ogata, Toru; Kumanishi, Ryosuke; Nakazawa, Taiko; Matsubara, Yuki; Kodama, Hiroyuki; Nakata, Atsushi; Honda, Kazuo; Masuishi, Toshiki; Bando, Hideaki; Kadowaki, Shigenori; Ando, Masashi; Ito, Seiji; Tajika, Masahiro; Muro, Kei

doi:10.1016/j.annonc.2021.08.1527

Cited by 2 publications

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“…When optimizing ramucirumab treatment for patients with AGC with poor prognosis, identifying clinicopathologic predictors of efficacy is crucial. Our study results showed that adding ramucirumab to FTD/TPI numerically improved PFS and OS in patients with LM, consistent with previous findings that VEGF inhibitors benefit patients with LM across various cancers [24][25][26] . This result is supported by our previous analysis of 1355 patients with AGC, in which we observed a significant OS improvement in cases with LM post-ramucirumab www.nature.com/scientificreports/ approval 25 .…”

Section: Discussionsupporting

confidence: 91%

“…Our study results showed that adding ramucirumab to FTD/TPI numerically improved PFS and OS in patients with LM, consistent with previous findings that VEGF inhibitors benefit patients with LM across various cancers [24][25][26] . This result is supported by our previous analysis of 1355 patients with AGC, in which we observed a significant OS improvement in cases with LM post-ramucirumab www.nature.com/scientificreports/ approval 25 . These results are consistent with those from major trials such as the RAINBOW 25,26 .…”

Section: Discussionsupporting

confidence: 91%

“…This result is supported by our previous analysis of 1355 patients with AGC, in which we observed a significant OS improvement in cases with LM post-ramucirumab approval 25 . These results are consistent with those from major trials such as the RAINBOW 25 , 26 . Preclinical data showed an association between anti-VEGF discontinuation and enhanced liver metastasis, indicating a strong correlation between VEGF and liver metastasis 27 .…”

Section: Discussionsupporting

confidence: 89%

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Trifluridine/tipiracil with and without ramucirumab for advanced gastric cancer: a comparative observational study

Narita,

Ogata,

Ishizuka

et al. 2024

Sci Rep

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The combination of trifluridine/tipiracil hydrochloride (FTD/TPI) plus ramucirumab has demonstrated clinical activity in patients with advanced gastric cancer (AGC). We evaluated the efficacy and safety of this combination compared with those of FTD/TPI monotherapy in patients with AGC. We retrospectively reviewed data of patients with AGC who received FTD/TPI plus ramucirumab or FTD/TPI monotherapy as third- or later-line treatment. This study included 36 patients treated with FTD/TPI plus ramucirumab and 70 patients receiving FTD/TPI monotherapy. The objective response rate (ORR) and disease control rate (DCR) were 25.8% and 58.1%, respectively, in the FTD/TPI plus ramucirumab group and 5.0% and 38.3%, respectively, in the FTD/TPI group (ORR, P = 0.007; DCR, P = 0.081). The median progression-free survival (PFS) was significantly longer in the FTD/TPI plus ramucirumab group (median PFS, 2.9 vs. 1.8 months; hazard ratio [HR]: 0.52; P = 0.001). A numerical survival benefit was also observed (median overall survival, 7.9 months vs. 5.0 months; HR: 0.68, P = 0.089). In the multivariate analysis, PFS was significantly longer in the FTD/TPI plus ramucirumab group than in the FTD/TPI monotherapy group (HR: 0.61, P = 0.030). The incidence of febrile neutropenia was higher in the FTD/TPI plus ramucirumab group than in the FTD/TPI group (13.8% vs. 2.9%); however, no new safety signals were identified. Compared with FTD/TPI monotherapy, FTD/TPI plus ramucirumab offers clinical benefits with acceptable toxicity in heavily pretreated patients with AGC. Further investigation via randomized trials is warranted to confirm these findings.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

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Trifluridine/tipiracil with and without ramucirumab for advanced gastric cancer: a comparative observational study

Narita,

Ogata,

Ishizuka

et al. 2024

Sci Rep

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“…A retrospective analysis involving 1,355 patients with mGEA who received treatment at the Aichi Cancer Center Hospital from 2005 to 2019 showed a remarkable improvement (from 14.3 to 19.3 months) among those with LM after the approval of RAM and nivolumab (from 2015 to 2019) [ 15 ]. This improvement was statistically significant in the multivariate analyses (HR, 0.45; 95% CI, 0.31–0.65; P<0.001).…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective analysis of patients with mGEA and LM who received treatment at the Aichi Cancer Center Hospital from 2005 to 2019 showed significant improvements in OS (P<0.001) after approval of ramucirumab and nivolumab (from 2015 to 2019) [ 15 ]. An improved benefit was also observed within the phase 3 RAINBOW-Asia LM subgroup analysis, as patients with LM tended to receive more benefit from RAM+PAC treatment than those without LM [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Exploratory Analysis of Patients With Gastric/Gastroesophageal Junction Adenocarcinoma With or Without Liver Metastasis From the Phase 3 RAINBOW Study

et al. 2023

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Purpose Liver metastasis (LM) is reported in approximately 40% of patients with advanced/metastatic gastric/gastroesophageal junction adenocarcinoma (metastatic esophagogastric adenocarcinoma; mGEA) and is associated with a worse prognosis. This post-hoc analysis from the RAINBOW trial reported the efficacy, safety, and biomarker outcomes of ramucirumab and paclitaxel combination treatment (RAM+PAC) in patients with (LM+) and without (LM−) LM at baseline. Materials and Methods Patients (n=665) were randomly assigned on a 1:1 basis to receive either RAM+PAC (LM+: 150, LM−: 180) or placebo and paclitaxel (PL+PAC) (LM+: 138, LM−: 197). The overall survival (OS) and progression-free survival (PFS) were evaluated using stratified Kaplan–Meier and Cox regression models. The correlation of dichotomized biomarkers (VEGF-C, D; VEGFR-1,2) with efficacy in the LM+ versus LM− subgroups was analyzed using the Cox regression model with reported interaction P-values. Results The presence of LM was associated with earlier progression than those without LM, particularly in patients receiving PL+PAC (hazard ratio [HR], 1.68). RAM+PAC treatment improved OS and PFS irrespective of LM status but showed greater improvement in LM+ than that in LM− (OS HR, 0.71 [LM+] vs. 0.88 [LM−]; PFS HR, 0.47 [LM+] vs. 0.76 [LM−]). Treatment-emergent adverse events were similar between patients with and without LM. No predictive relationship was observed between biomarker levels (VEGF-C, D; VEGFR-1,2) and efficacy outcome (OS, PFS) (all interaction P-values >0.05). Conclusions RAM provided a significant benefit, irrespective of LM status; however, its effect was numerically stronger in patients with LM. Therefore, RAM+PAC is a clinically meaningful therapeutic option for patients with mGEA and LM. Trial Registration ClinicalTrials.gov Identifier: NCT01170663

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1418P Chronological improvement in the survival of advanced gastric cancer patients in the past 15 years

Cited by 2 publications

References 0 publications

Trifluridine/tipiracil with and without ramucirumab for advanced gastric cancer: a comparative observational study

Trifluridine/tipiracil with and without ramucirumab for advanced gastric cancer: a comparative observational study

Exploratory Analysis of Patients With Gastric/Gastroesophageal Junction Adenocarcinoma With or Without Liver Metastasis From the Phase 3 RAINBOW Study

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