Predictive value of genomic profile in patients receiving Ramucirumab as Second line therapy in advanced Or Metastatic Gastric Cancer

ABSTRACT

Introduction: Localized form of gastric cancer is currently treated, independently of genetic profiles, by surgical resection with perioperative chemotherapy, radiotherapy and/or targeted therapy. Next-generation sequencing (NGS) recently provided new information regarding gene mutations related to gastric cancer pathogenesis. This information can determine new therapeutic pathways to successfully treat gastric cancer depending on its molecular profiling. Ramucirumab is a humanized monoclonal antibody directed against vascular endothelial growth factor receptor 2. Ramucirumab is approved in second-line therapy for advanced or metastatic gastric cancer as a single agent or combined with chemotherapy in molecularly unselected patients. Some studies determined prognostic value of plasma biomarkers and cytokines in patients treated with Ramucirumab (RAINBOW trial). Other studies have shown no relationship between Ramucirumab therapy and VEGFR-2 mutation (REGARD trial). However, no studies have shown significant survival benefit for certain genetic profiles in patients treated with Ramucirumab therapy. The aim of this study is to assess the value of certain molecular profiles in predicting response to Ramucirumab therapy in advanced or metastatic gastric cancer