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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

  • Alessandro Parisi
  • Alessio CortelliniEmail author
  • Michela Roberto
  • Olga Venditti
  • Daniele Santini
  • Emanuela Dell’Aquila
  • Marco Stellato
  • Paolo Marchetti
  • Mario Alberto Occhipinti
  • Federica Zoratto
  • Federica Mazzuca
  • Nicola Tinari
  • Michele De Tursi
  • Laura Iezzi
  • Clara Natoli
  • Margherita Ratti
  • Claudio Pizzo
  • Michele Ghidini
  • Giampiero Porzio
  • Corrado Ficorella
  • Katia Cannita
Original Article – Clinical Oncology
  • 101 Downloads

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%).

Keywords

Advanced gastric cancer Ramucirumab Body mass index Body weight loss Prognostic factors Second-line chemotherapy 

Notes

Acknowledgements

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

Authors’ 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.

Funding

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

Compliance with ethical standards

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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Alessandro Parisi
    • 1
    • 2
  • Alessio Cortellini
    • 1
    • 2
    Email author
  • Michela Roberto
    • 3
  • Olga Venditti
    • 1
  • Daniele Santini
    • 4
  • Emanuela Dell’Aquila
    • 4
  • Marco Stellato
    • 4
  • Paolo Marchetti
    • 3
    • 5
    • 6
  • Mario Alberto Occhipinti
    • 6
  • Federica Zoratto
    • 7
  • Federica Mazzuca
    • 3
  • Nicola Tinari
    • 8
  • Michele De Tursi
    • 8
  • Laura Iezzi
    • 8
  • Clara Natoli
    • 8
  • Margherita Ratti
    • 9
  • Claudio Pizzo
    • 9
  • Michele Ghidini
    • 10
  • Giampiero Porzio
    • 1
    • 2
  • Corrado Ficorella
    • 1
    • 2
  • Katia Cannita
    • 1
  1. 1.Medical Oncology, St. Salvatore Hospital, University of L’AquilaL’AquilaItaly
  2. 2.Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
  3. 3.Medical OncologySant’Andrea HospitalRomeItaly
  4. 4.Medical OncologyCampus Bio-Medico University of RomeRomeItaly
  5. 5.Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
  6. 6.Medical OncologyPoliclinico Umberto IRomeItaly
  7. 7.Medical OncologySanta Maria Goretti HospitalLatinaItaly
  8. 8.Department of Medical, Oral and Biotechnological SciencesUniversity G. D’AnnunzioChieti-PescaraItaly
  9. 9.Oncology Unit, Oncology DepartmentAzienda Socio Sanitaria Territoriale Ospedale di CremonaCremonaItaly
  10. 10.Medical Oncology UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly

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