Advertisement

Retrospective comparison of nab-paclitaxel plus ramucirumab and paclitaxel plus ramucirumab as second-line treatment for advanced gastric cancer focusing on peritoneal metastasis

  • Masashi IshikawaEmail author
  • Satoru Iwasa
  • Kengo Nagashima
  • Masahiko Aoki
  • Hiroshi Imazeki
  • Hidekazu Hirano
  • Hirokazu Shoji
  • Yoshitaka Honma
  • Natsuko Okita
  • Atsuo Takashima
  • Ken Kato
  • Masayuki Saruta
  • Narikazu Boku
SHORT REPORT
  • 389 Downloads

Summary

Background Ramucirumab (RAM) plus solvent-based (sb)-paclitaxel (PTX) is the standard second-line chemotherapy for advanced gastric cancer (AGC). The subset analysis of the ABSOLUTE trial, which confirmed non-inferiority of weekly nanoparticle albumin-bound (nab)-PTX to weekly sb-PTX, suggested that nab-PTX might have better efficacy than sb-PTX in patients with peritoneal metastasis. We retrospectively evaluated the efficacy and safety of RAM plus sb-PTX and nab-PTX in patients with peritoneal metastasis of AGC. Methods AGC patients who received RAM plus sb-PTX or nab-PTX as second-line chemotherapy from June 2015 to February 2019 were included in the study. Overall survival (OS), progression-free survival (PFS), response rate, and safety were assessed. Results A total of 128 patients were included in this study (93 in the RAM plus sb-PTX group and 35 in the RAM plus nab-PTX group). PFS was 4.1 months in the RAM plus sb-PTX group and 4.6 months in the RAM plus nab-PTX group (HR 0.90; 95%CI 0.58–1.41, p = 0.643). OS was 8.9 months in the RAM plus sb-PTX group and 11.4 months in the RAM plus nab-PTX group (HR 0.95; 95%CI 0.56–1.62, p = 0.847). A total of 62 and 31 patients had peritoneal metastasis in the RAM plus sb-PTX and the RAM plus nab-PTX groups, respectively. RAM plus nab-PTX showed a slightly longer survival compared to RAM plus sb-PTX in patients with peritoneal metastasis (PFS 5.8 vs 3.5 months, HR 0.66; 95% CI 0.40–1.10, p = 0.109). Conclusion This study suggests that RAM plus nab-PTX might be a more effective treatment for peritoneal metastasis of AGC.

Keywords

Nab-paclitaxel Gastric cancer Peritoneal metastasis Ramucirumab 

Notes

Compliance with ethical standards

Conflict of interest

Masashi Ishikawa declares that he has no conflict of interest.

Satoru Iwasa declares that he has no conflict of interest.

Kengo Nagashima declares that he has no conflict of interest.

Masahiko Aoki declares that he has no conflict of interest.

Hiroshi Imazeki declares that he has no conflict of interest.

Hidekazu Hirano declares that he has no conflict of interest.

Hirokazu Shoji declares that he has no conflict of interest.

Yoshitaka Honma declares that he has no conflict of interest.

Natsuko Okita declares that he has no conflict of interest.

Atsuo Takashima declares that he has no conflict of interest.

Ken Kato declares that he has no conflict of interest.

Masayuki Saruta declares that he has no conflict of interest.

Narikazu Boku declares that he has no conflict of interest.

Ethical approval

This study was approved by the ethics committee of the National Cancer Center Hospital.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424CrossRefGoogle Scholar
  2. 2.
    Wilke H, Muro K, Van Cutsem E et al (2014) Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial. Lancet Oncol 151:1224–1235CrossRefGoogle Scholar
  3. 3.
    Shitara K, Muro K, Shimada Y et al (2016) Subgroup analyses of the safety and efficacy of ramucirumab in Japanese and Western patients in RAINBOW: a randomized clinical trial in second-line treatment of gastric cancer. Gastric Cancer 19:927–938CrossRefGoogle Scholar
  4. 4.
    Shitara K, Takashima A, Fujitani K, Koeda K, Hara H, Nakayama N et al (2017) Nab-paclitaxel versus solvent-based paclitaxel in patients with previously treated advanced gastric cancer (ABSOLUTE): an open-label, randomised, non-inferiority, phase 3 trial. Lancet Gastroenterol Hepatol 2:277–287CrossRefGoogle Scholar
  5. 5.
    Takashima A, Shitara K, Fujitani K et al (2019) Peritoneal metastasis as a predictive factor for nab-paclitaxel in patients with pretreated advanced gastric cancer: an exploratory analysis of the phase III ABSOLUTE trial. Gastric Cancer 22:155–163CrossRefGoogle Scholar
  6. 6.
    Bando H, Shimodaira H, Fujitani K et al (2018) A phase II study of nab-paclitaxel in combination with ramucirumab in patients with previously treated advanced gastric cancer. Eur J Cancer 91:86–91CrossRefGoogle Scholar
  7. 7.
    Hawkins MJ, Soon-Shiong P, Desai N et al (2008) Protein nanoparticles as drug carriers in clinical medicine. Adv Drug Deliv Rev 60:876–885CrossRefGoogle Scholar
  8. 8.
    Schnitzer JE (1992) gp60 is an albumin-binding glycoprotein expressed by continuous endothelium involved in albumin transcytosis. Am J Phys 262:246–254Google Scholar
  9. 9.
    Minshall RD, Tiruppathi C, Vogel SM, Niles WD, Gilchrist A, Hamm HE et al (2000) Endothelial cell-surface gp60 activates vesicle formation and trafficking via G(i)-coupled Src kinase signaling pathway. J Cell Biol 150:1057–1069CrossRefGoogle Scholar
  10. 10.
    Vogel SM, Minshall RD, Pilipović M, Tiruppathi C, Malik AB (2001) Albumin uptake and transcytosis in endothelial cells in vivo induced by albumin-binding protein. Am J Phys Lung Cell Mol Phys 281:1512–1522Google Scholar
  11. 11.
    Coccolini F, Acocella F, Morosi L, Brizzola S, Ghiringhelli M, Ceresoli M et al (2017) High penetration of paclitaxel in abdominal wall of rabbits after hyperthermic intraperitoneal administration of nab-paclitaxel compared to standard paclitaxel formulation. Pharm Res 34:1180–1186CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Masashi Ishikawa
    • 1
    • 2
    Email author
  • Satoru Iwasa
    • 1
  • Kengo Nagashima
    • 3
    • 4
  • Masahiko Aoki
    • 1
  • Hiroshi Imazeki
    • 1
  • Hidekazu Hirano
    • 1
  • Hirokazu Shoji
    • 1
  • Yoshitaka Honma
    • 1
  • Natsuko Okita
    • 1
  • Atsuo Takashima
    • 1
  • Ken Kato
    • 1
  • Masayuki Saruta
    • 2
  • Narikazu Boku
    • 1
  1. 1.Gastrointestinal Medical Oncology DivisionNational Cancer Center HospitalChuo-kuJapan
  2. 2.Division of Gastroenterology and Hepatology, Department of Internal MedicineThe Jikei University School of MedicineMinato-kuJapan
  3. 3.Research Center for Medical and Health Data ScienceThe Institute of Statistical MathematicsTachikawaJapan
  4. 4.Keio University School of MedicineShinjuku-kuJapan

Personalised recommendations