Retrospective comparison of nab-paclitaxel plus ramucirumab and paclitaxel plus ramucirumab as second-line treatment for advanced gastric cancer focusing on peritoneal metastasis
Retrospective comparison of nab-paclitaxel plus ramucirumab and paclitaxel plus ramucirumab as second-line treatment for advanced gastric cancer focusing on peritoneal metastasis
复制标题
DOI：
10.1007/s10637-019-00822-3
复制
发表时间：
2020-04-01
影响因子：
3.4
通讯作者：
Boku, Narikazu
中科院分区：
文献类型：
--
作者：
Ishikawa, Masashi;Iwasa, Satoru;Boku, Narikazu
Ramucirumab （RAM）联合溶剂型（sb）紫杉醇（PTX）是晚期胃癌（AGC）的标准二线化疗方案。ABSOLUTE试验的亚群分析证实了每周纳米颗粒白蛋白结合(nab)-PTX与每周sb-PTX的非劣效性，这表明nab-PTX可能比sb-PTX对腹膜转移患者有更好的疗效。我们回顾性评价RAM联合sb-PTX和nab-PTX治疗AGC腹膜转移患者的疗效和安全性。方法纳入2015年6月至2019年2月期间接受RAM联合sb-PTX或nab-PTX作为二线化疗的AGC患者。评估总生存期（OS）、无进展生存期（PFS）、反应率和安全性。结果本研究共纳入128例患者，其中RAM + sb-PTX组93例，RAM + nab-PTX组35例。RAM + sb-PTX组PFS为4.1个月，RAM + nab-PTX组PFS为4.6个月（HR 0.90; 95%CI 0.58-1.41, p = 0.643）。RAM + sb-PTX组OS为8.9个月，RAM + nab-PTX组OS为11.4个月（HR 0.95; 95%CI 0.56-1.62, p = 0.847）。RAM + sb-PTX组和RAM + nab-PTX组分别有62例和31例患者发生腹膜转移。与RAM + sb-PTX相比，RAM + nab-PTX在腹膜转移患者中的生存时间略长（PFS 5.8 vs 3.5个月，HR 0.66; 95% CI 0.40-1.10, p = 0.109）。结论RAM联合nab-PTX治疗AGC腹膜转移可能更有效。
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.