A phase II study of nab-paclitaxel in combination with ramucirumab in patients with previously treated advanced gastric cancer

作者：Bando Hideaki; Shimodaira Hideki; Fujitani Kazumasa; Takashima Atsuo; Yamaguchi Kensei; Nakayama Norisuke; Takahashi Takehiro; Oki Eiji; Azuma Mizutomo; Nishina Tomohiro; Hironaka Shuichi; Komatsu Yoshito; Shitara Kohei^*

来源：European Journal of Cancer, 2018, 91: 86-91.

DOI：10.1016/j.ejca.2017.11.032

• Advanced gastric cancer
• Nab-paclitaxel
• Paclitaxel
• Ramucirumab
• Overall response rate
• Second-line chemotherapy

Background: Nanoparticle albumin-bound (nab)-paclitaxel was developed to improve paclitaxel solubility and does not need premedication to avoid infusion-related reactions associated with solvent-based (sb)-paclitaxel. We conducted a phase II trial to investigate the efficacy and safety of nab-paclitaxel plus ramucirumab combination therapy for previously treated advanced gastric cancer.
Patients and methods: Patients with unresectable advanced gastric cancer refractory to first-line chemotherapy were administered nab-paclitaxel 100 mg/m(2) intravenously on days 1, 8 and 15, plus ramucirumab 8 mg/kg intravenously on days 1 and 15 of a 28-day cycle. The primary end-point was Independent Review Committee (IRC)-assessed overall response rate (ORR). Secondary end-points were progression-free survival (PFS), overall survival (OS), disease control rate (DCR), safety and quality of life (QOL).
Results: Forty-five patients were enrolled; 43 received the study treatment. The ORR assessed by the IRC was 54.8% (90% confidence interval [CI] 41.0-68.0) and the primary end-point was met. The DCR was 92.9% (95% CI 80.5-98.5). The IRC-assessed median PFS was 7.6 months (95% CI 5.4-8.1). The median OS was not reached at the data cutoff. The main treatment-related grade 3 or 4 adverse events were decreased neutrophil count (76.7%), decreased white blood cell count (27.9%), anaemia (11.6%), decreased appetite (7.0%), febrile neutropenia (4.7%), hypertension (4.7%) and proteinuria (4.7%). No treatment-related deaths occurred. No QOL deterioration was observed during study treatment.
Conclusion: Nab-paclitaxel plus ramucirumab combination therapy shows promising activity and manageable toxicities and could be a useful second-line treatment option for patients with previously treated advanced gastric cancer.

• 出版日期2018-3
• 单位中国医学科学院肿瘤医院