Tolerance of ramucirumab in the second-line therapy of patients with disseminated gastric cancer in the routine clinical practice of Russia

Abstract

Introduction: Ramucirumab (Ram), a human IgG 1 antibody against vascular endothelial growth factor receptor 2. This multicenter retrospective study aims to reviewed the results of Ram-based therapy as second-line treatment in patients with advanced gastric cancer in a real-life setting.Methods: it was an observational, retrospective study carried out in 11 Russian hospitals. Endpoints included safety, overall survival (OS), progression-free survival (PFS), objective response rate (ORR).Results: 163 patients were included. Ram was used as the second- line in 166 combined with weekly paclitaxel (PTX) in 104 patients or irinotecan-based chemotherapy (mostly FOLFIRI) in 42 patients and as monotherapy in 17 patient. In second line VEGF-related toxicity (all grades) included epistaxis (39,2%), proteinuria >1g/day (4.9%), and arterial hypertension (68%); grade 3-4 toxicity was bleeding (4.3%), perforation (2,4%), venous thrombosis (6,13%) and brain ischemia (0.6%, grade 5). 15 patients (9,2%) discontinued therapy due to toxicity.Conclusion: These real-life efficacy data of ramucirumab are in line with previous randomized trials. Ramucirumab is well tolerated in daily clinical practice.

Keywords

• ramucirumab
• gastric cancer
• irinotecan
• fluoropyrimidine adenocarcinoma
• second line treatment