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Efficacy of ramucirumab combination chemotherapy as second-line treatment in patients with advanced adenocarcinoma of the stomach or gastroesophageal junction after exposure to checkpoint inhibitors and chemotherapy as first-line therapy.
Masetti, Michael; Al-Batran, Salah-Eddin; Goetze, Thorsten O; Thuss-Patience, Peter; Knorrenschild, Jorge Riera; Goekkurt, Eray; Folprecht, Gunnar; Ettrich, Thomas Jens; Lindig, Udo; Luley, Kim Barbara; Pink, Daniel; Dechow, Tobias; Sookthai, Disorn; Junge, Sabine; Loose, Maria; Pauligk, Claudia; Lorenzen, Sylvie.
Afiliação
  • Masetti M; Klinikum rechts der Isar, Technische Universität München, Klinik für Innere Medizin III, Munich, Germany.
  • Al-Batran SE; Institut für Klinische Krebsforschung IKF am Krankenhaus Nordwest, Frankfurt, Germany and Krankenhaus Nordwest, University Cancer Center Frankfurt, Frankfurt, Germany.
  • Goetze TO; Institut für Klinische Krebsforschung IKF am Krankenhaus Nordwest, Frankfurt, Germany and Krankenhaus Nordwest, University Cancer Center Frankfurt, Frankfurt, Germany.
  • Thuss-Patience P; Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
  • Knorrenschild JR; Klinik für Innere Medizin, Universitätsklinikum Marburg, Marburg, Germany.
  • Goekkurt E; Haematologisch-Onkologische Praxis Eppendorf, Universitäres Cancer Center Hamburg (UCCH), Hamburg, Germany.
  • Folprecht G; Medizinische Klinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
  • Ettrich TJ; Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany.
  • Lindig U; Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany.
  • Luley KB; UKSH Campus Lübeck, Klinik für Hämatologie und Onkologie, Lübeck, Germany.
  • Pink D; Klinik und Poliklinik für Innere Medizin C, Hämatologie und Onkologie, Transplantationszentrum, Palliativmedizin, Universität Greifswald and Klinik für Hämatologie, Onkologie und Palliativmedizin-Sarkomzentrum, HELIOS Klinikum Bad Saarow, Bad Saarow, Germany.
  • Dechow T; Onkologie Ravensburg, Ravensburg, Germany.
  • Sookthai D; Institut für Klinische Krebsforschung IKF am Krankenhaus Nordwest, Frankfurt, Germany.
  • Junge S; Institut für Klinische Krebsforschung IKF am Krankenhaus Nordwest, Frankfurt, Germany.
  • Loose M; Institut für Klinische Krebsforschung IKF am Krankenhaus Nordwest, Frankfurt, Germany.
  • Pauligk C; Institut für Klinische Krebsforschung IKF am Krankenhaus Nordwest, Frankfurt, Germany.
  • Lorenzen S; Klinikum rechts der Isar, Technische Universität München, Klinik für Innere Medizin III, Munich, Germany.
Int J Cancer ; 154(12): 2142-2150, 2024 Jun 15.
Article em En | MEDLINE | ID: mdl-38447003
ABSTRACT
FOLFOX plus nivolumab represents a standard of care for first-line therapy of advanced gastroesophageal cancer (aGEC) with positive PD-L1 expression. The efficacy of second-line VEGFR-2 inhibition with ramucirumab (RAM) plus chemotherapy after progression to immunochemotherapy remains unclear. Medical records of patients with aGEC enrolled in the randomized phase II AIO-STO-0417 trial after treatment failure to first-line FOLFOX plus nivolumab and ipilimumab were retrospectively analyzed. Patients were divided into two groups based on second-line therapy RAM plus chemotherapy (RAM group) or treatment without RAM (control group). Eighty three patients were included. In the overall population, progression-free survival (PFS) in the RAM group was superior to the control (4.5 vs 2.9 months). Responders (CR/PR) to first-line immunochemotherapy receiving RAM containing second-line therapy had prolonged OS from start of first-line therapy (28.9 vs 16.5 months), as well as second-line OS (9.6 vs 7.5 months), PFS (5.6 vs 2.9 months) and DCR (53% vs 29%) compared to the control. PD-L1 CPS ≥1 was 42% and 44% for the RAM and the control, respectively. Patients with CPS ≥1 in the RAM group showed better tumor control (ORR 25% vs 10%) and improved survival (total OS 11.5 vs 8.0 months; second-line OS 6.5 vs 3.9 months; PFS 4.5 vs 1.6 months) compared to the control. Prior exposure to first-line FOLFOX plus dual checkpoint inhibition followed by RAM plus chemotherapy shows favorable response and survival rates especially in patients with initial response and positive PD-L1 expression and has the potential to advance the treatment paradigm in aGEC.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas / Adenocarcinoma Limite: Humans Idioma: En Revista: Int J Cancer Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Gástricas / Adenocarcinoma Limite: Humans Idioma: En Revista: Int J Cancer Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha