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Weight loss and body mass index in advanced gastric cancer patients treated with second-line ramucirumab: a real-life multicentre study

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Aims and methods

This multicenter retrospective study aims to evaluate the correlations between Body Weight Loss (BWL), Body Mass Index (BMI) and clinical outcomes (ORR, PFS, and OS) of advanced gastric cancer (aGC) patients treated with second-line ramucirumab-based therapy in a “real-life” setting.

Results

From December 2014 to October 2018, 101 consecutive aGC patients progressed to a first-line chemotherapy were treated with ramucirumab alone (10.9%) or in combination with paclitaxel (89.1%). Median BMI was 21.2 kg/m2 and mBWL since first-line treatment commencement was 4.5%. Among 53 patients who underwent primary tumor resection (PTR), 73.6% experienced BWL, while 26.4% did not experience BWL (p = 0.0429). Patients who underwent PTR had a significantly higher probability of experiencing BWL (yes vs no) [OR = 2.35 (95% CI 1.02–5.42), p = 0.0439]. Among the 89 evaluable patients, ORR was 26.9% (95% CI 17.2–40.1). At a median follow-up of 17.3 months, mPFS was 5.4 months (95% CI 3.6–6.8) and mOS was 8.7 months (95% CI 7.3–11.9). In the multivariate analysis, only ECOG-PS and BMI were confirmed independent predictors for shorter PFS [HR = 1.69 (95% CI 1.01–2.82), p = 0.04] [HR = 1.97 (95% CI 1.12–3.46), p = 0.01] and OS [HR = 1.69 (95% CI 1.01–2.83), p = 0.04] [HR = 2.08 (95% CI 1.17–3.70), p = 0.01].

Conclusion

Efficacy of ramucirumab is confirmed in this “real-life” analysis. BWL seems not to have correlations with clinical outcomes in these patients, while BMI and ECOG-PS remain major prognostic factors. A possible explanation for the lack of prognostic effect of BWL might be the proportion of patients subjected to PTR in this series (52.5%).

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Availability of data and materials

The data sets used during the present study are available from the corresponding author upon reasonable request.

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Acknowledgements

This work was supported by the Consorzio Interuniversitario Nazionale per la Bio-Oncologia (CINBO).

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Medical Oncology, St. Salvatore Hospital, University of L’Aquila, Via Vetoio, 67100, L’Aquila, Italy

    Alessandro Parisi, Alessio Cortellini, Olga Venditti, Giampiero Porzio, Corrado Ficorella & Katia Cannita

  2. Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy

    Alessandro Parisi, Alessio Cortellini, Giampiero Porzio & Corrado Ficorella

  3. Medical Oncology, Sant’Andrea Hospital, Rome, Italy

    Michela Roberto, Paolo Marchetti & Federica Mazzuca

  4. Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy

    Daniele Santini, Emanuela Dell’Aquila & Marco Stellato

  5. Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy

    Paolo Marchetti

  6. Medical Oncology, Policlinico Umberto I, Rome, Italy

    Paolo Marchetti & Mario Alberto Occhipinti

  7. Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy

    Federica Zoratto

  8. Department of Medical, Oral and Biotechnological Sciences, University G. D’Annunzio, Chieti-Pescara, Italy

    Nicola Tinari, Michele De Tursi, Laura Iezzi & Clara Natoli

  9. Oncology Unit, Oncology Department, Azienda Socio Sanitaria Territoriale Ospedale di Cremona, Cremona, Italy

    Margherita Ratti & Claudio Pizzo

  10. Medical Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Michele Ghidini

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  1. Alessandro Parisi
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  2. Alessio Cortellini
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Contributions

All authors contributed to the publication according to the ICMJE guidelines for the authorship. All authors read and approved the manuscript and agree to be accountable for all aspects of the research in ensuring that the accuracy or integrity of any part of the work is appropriately investigated and resolved.

Corresponding author

Correspondence to Alessio Cortellini.

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Conflict of interest

Dr Alessio Cortellini received grants as speaker by MSD, Astra-Zeneca and Boehringer Ingelheim, gran consultancies by BMS, Roche, Novartis, Istituto Gentili and Ipsen.

Informed consent

All patients provided informed consent to participate in this observational non-interventional study.

Ethical statement

The procedures followed were in accordance with the precepts of Good Clinical Practice and the Declaration of Helsinki. The study was conducted following the rules of the local bioethical committee competent on human experimentation (Comitato etico per le province di L’Aquila e Teramo).

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Parisi, A., Cortellini, A., Roberto, M. et al. Weight loss and body mass index in advanced gastric cancer patients treated with second-line ramucirumab: a real-life multicentre study. J Cancer Res Clin Oncol 145, 2365–2373 (2019). https://doi.org/10.1007/s00432-019-02971-7

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