BMC Gastroenterology (Mar 2023)

Use of ramucirumab for various treatment lines in real-world practice of patients with advanced hepatocellular carcinoma

  • Naoya Kanogawa,
  • Sadahisa Ogasawara,
  • Susumu Maruta,
  • Yotaro Iino,
  • Masamichi Obu,
  • Takamasa Ishino,
  • Keita Ogawa,
  • Sae Yumita,
  • Terunao Iwanaga,
  • Hidemi Unozawa,
  • Miyuki Nakagawa,
  • Kisako Fujiwara,
  • Takafumi Sakuma,
  • Naoto Fujita,
  • Ryuta Kojima,
  • Hiroaki Kanzaki,
  • Keisuke Koroki,
  • Kazufumi Kobayashi,
  • Masanori Inoue,
  • Soichiro Kiyono,
  • Masato Nakamura,
  • Takayuki Kondo,
  • Tomoko Saito,
  • Ryo Nakagawa,
  • Shingo Nakamoto,
  • Ryosuke Muroyama,
  • Tetsuhiro Chiba,
  • Ei Itobayashi,
  • Yoshihiro Koma,
  • Ryosaku Azemoto,
  • Jun Kato,
  • Naoya Kato

DOI
https://doi.org/10.1186/s12876-023-02674-x
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 10

Abstract

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Abstract Purpose Ramucirumab was shown to be effective as a second-line treatment after sorafenib in patients with advanced hepatocellular carcinoma (HCC) with alpha-fetoprotein levels > 400 ng/mL in a worldwide phase 3 trial. Ramucirumab is used in patients pretreated with various systemic therapies in clinical practice. We retrospectively examined the treatment outcomes of ramucirumab administered to advanced HCC patients after diverse systemic therapies. Methods Data were collected from patients with advanced HCC who received ramucirumab at three institutions in Japan. Radiological assessments were determined according to both Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1 and modified RECIST and the Common Terminology Criteria for Adverse Events version 5.0 was used to assess adverse events. Results A total of 37 patients treated with ramucirumab between June 2019 and March 2021 were included in the study. Ramucirumab was administered as second, third, fourth, and fifth-line treatment in 13 (35.1%), 14 (37.8%), eight (21.6%), and two (5.4%) patients, respectively. Most patients (29.7%) who received ramucirumab as a second-line therapy were pretreated with lenvatinib. We found grade 3 or higher adverse events only in seven patients and no significant changes in the albumin-bilirubin score during ramucirumab treatment in the present cohort. The median progression-free survival of patients treated with ramucirumab was 2.7 months (95% confidence interval, 1.6–7.3). Conclusion Although ramucirumab is used for various lines of treatment other than second-line immediately after sorafenib, its safety and effectiveness were not significantly different from the findings of the REACH-2 trial.

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