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Background and purpose <p>Taxane plus ramucirumab (RAM) is the standard second-line treatment for advanced gastric cancer (AGC). However, data on second-line therapy following first-line treatment with nivolumab remains limited. This study aimed to evaluate the efficacy, safety, and prognostic factors of taxane plus RAM in patients with advanced AGC who previously received chemotherapy plus nivolumab.</p> Materials and methods <p>We collected data from AGC patients at multiple institutions who received taxane plus RAM after failure of chemotherapy plus nivolumab. All patients received first-line chemotherapy with nivolumab before December 2022.</p> Results <p>In total, 51 patients received taxane plus RAM (41 received paclitaxel plus RAM, and ten received nab-paclitaxel plus RAM). The median age was 70&#xa0;years (range 41–83), 30 (59%) patients were male, and 45 (89%) had PS 0/1. Fourteen patients (27%) had liver metastases, 30 (59%) had peritoneal dissemination, and 25 (49%) had ascites; 43 patients had measurable lesions, nine (21%) achieved a partial response, and 21 (49%) achieved stable disease. Median progression-free survival was 3.7&#xa0;months (95% confidence interval (CI) 3.1–5.1) and median overall survival was 8.9&#xa0;months (95% CI 6.3–11.6). Major adverse events of grade 3 or higher were neutropenia (41%), anemia (10%), febrile neutropenia (8%), proteinuria (6%), and infection (4%). Multivariate analysis showed that ascites was a poor prognostic factor for overall survival.</p> Conclusion <p>Taxane plus RAM was effective in patients with AGC who have received prior chemotherapy plus nivolumab. The presence of ascites may be a poor prognostic factor in patients receiving taxane plus RAM.</p>

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Efficacy and safety of taxane plus ramucirumab for advanced gastric cancer after chemotherapy plus nivolumab

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月7日

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  • Toshihiko Matsumoto,
  • Tatsuki Ikoma,
  • Chinatsu Makiyama,
  • Tomoyo Yasuda,
  • Shogen Boku,
  • Akio Nakasya,
  • Nobuhiro Shibata,
  • Hiroki Nagai,
  • Takao Tsuduki,
  • Yusuke Matsumoto,
  • Hisateru Yasui,
  • Reiji Higashi,
  • Akitoshi Sasamoto,
  • Hironaga Satake,
  • Kentaro Inoue,
  • Masashi Kanai,
  • Makoto Yamasaki

摘要

Background and purpose

Taxane plus ramucirumab (RAM) is the standard second-line treatment for advanced gastric cancer (AGC). However, data on second-line therapy following first-line treatment with nivolumab remains limited. This study aimed to evaluate the efficacy, safety, and prognostic factors of taxane plus RAM in patients with advanced AGC who previously received chemotherapy plus nivolumab.

Materials and methods

We collected data from AGC patients at multiple institutions who received taxane plus RAM after failure of chemotherapy plus nivolumab. All patients received first-line chemotherapy with nivolumab before December 2022.

Results

In total, 51 patients received taxane plus RAM (41 received paclitaxel plus RAM, and ten received nab-paclitaxel plus RAM). The median age was 70 years (range 41–83), 30 (59%) patients were male, and 45 (89%) had PS 0/1. Fourteen patients (27%) had liver metastases, 30 (59%) had peritoneal dissemination, and 25 (49%) had ascites; 43 patients had measurable lesions, nine (21%) achieved a partial response, and 21 (49%) achieved stable disease. Median progression-free survival was 3.7 months (95% confidence interval (CI) 3.1–5.1) and median overall survival was 8.9 months (95% CI 6.3–11.6). Major adverse events of grade 3 or higher were neutropenia (41%), anemia (10%), febrile neutropenia (8%), proteinuria (6%), and infection (4%). Multivariate analysis showed that ascites was a poor prognostic factor for overall survival.

Conclusion

Taxane plus RAM was effective in patients with AGC who have received prior chemotherapy plus nivolumab. The presence of ascites may be a poor prognostic factor in patients receiving taxane plus RAM.