内容紹介
Summary
The RAINBOW trial showed that paclitaxel(PTX)plus ramucirumab(RAM)therapy improved the survival of patients with advanced gastric cancer, previously treated with chemotherapy. We retrospectively investigated 33 patients with unresectable or recurrent gastric cancer who underwent PTX plus RAM treatment as second- or third-line chemotherapy between September 2015 and December 2017. The median age was 68(45-84)years with 22 patients(67%)aged 65 years or older. Seventeen patients had unresectable and 16 patients had recurrent gastric cancer. ECOG PS was 2 in 5 patients(16%). PTX plus RAM was administered as second-line therapy for 24 patients, and as third-line therapy for 9 patients. Best overall response was partial response(PR)in 4 patients, stable disease(SD)in 14 patients, and progressive disease(PD)in 9 patients. Response rate(RR)and disease control rate(DCR)were 14.8% and 66.7%, respectively. Grade 3/4 adverse events were observed in 28(85%)of(leucopenia・neutropenia[64%], neuropathy[9%], etc). Median follow-up period was 7.3(0.4-22.4)months. Median OS and PFS were 9.3(0.4-22.4)months and 4.7(0.4-22.4)months, respectively. We conclude that PTX plus RAM therapy is useful for treating unresectable or recurrent gastric cancer. In clinical practice, we have many opportunities to provide PTX plus RAM therapy for patients of older age and poorer PS; careful attention to adverse events is essential in such cases.
要旨
進行・再発胃癌に対する二次以降の化学療法として施行したpaclitaxel(PTX)+ramucirumab(RAM)療法(PTX 80 mg/m2,day 1,8,15,RAM 8 mg/kg,day 1,15)の安全性および有効性について検討した。対象は当科でPTX+RAM療法を施行した進行・再発胃癌33例で,年齢中央値は68歳,PS 2以上の症例は5例であった。投与コース数の中央値は4コースで,Grade 3以上の有害事象は28例(85%)[白血球・好中球減少21例(64%),末梢神経障害3例(9%)など]に認められた。抗腫瘍効果は奏効率14.8%,病勢コントロール率66.7%であり,全生存期間および無増悪生存期間中央値はそれぞれ9.3か月,4.7か月であった。切除不能進行・再発胃癌に対するPTX+RAM療法は一定の効果が期待できるが,実地臨床においては高齢かつPSの悪い症例に対して使用することも多く,慎重なマネージメントが必要である。
目次
The RAINBOW trial showed that paclitaxel(PTX)plus ramucirumab(RAM)therapy improved the survival of patients with advanced gastric cancer, previously treated with chemotherapy. We retrospectively investigated 33 patients with unresectable or recurrent gastric cancer who underwent PTX plus RAM treatment as second- or third-line chemotherapy between September 2015 and December 2017. The median age was 68(45-84)years with 22 patients(67%)aged 65 years or older. Seventeen patients had unresectable and 16 patients had recurrent gastric cancer. ECOG PS was 2 in 5 patients(16%). PTX plus RAM was administered as second-line therapy for 24 patients, and as third-line therapy for 9 patients. Best overall response was partial response(PR)in 4 patients, stable disease(SD)in 14 patients, and progressive disease(PD)in 9 patients. Response rate(RR)and disease control rate(DCR)were 14.8% and 66.7%, respectively. Grade 3/4 adverse events were observed in 28(85%)of(leucopenia・neutropenia[64%], neuropathy[9%], etc). Median follow-up period was 7.3(0.4-22.4)months. Median OS and PFS were 9.3(0.4-22.4)months and 4.7(0.4-22.4)months, respectively. We conclude that PTX plus RAM therapy is useful for treating unresectable or recurrent gastric cancer. In clinical practice, we have many opportunities to provide PTX plus RAM therapy for patients of older age and poorer PS; careful attention to adverse events is essential in such cases.
要旨
進行・再発胃癌に対する二次以降の化学療法として施行したpaclitaxel(PTX)+ramucirumab(RAM)療法(PTX 80 mg/m2,day 1,8,15,RAM 8 mg/kg,day 1,15)の安全性および有効性について検討した。対象は当科でPTX+RAM療法を施行した進行・再発胃癌33例で,年齢中央値は68歳,PS 2以上の症例は5例であった。投与コース数の中央値は4コースで,Grade 3以上の有害事象は28例(85%)[白血球・好中球減少21例(64%),末梢神経障害3例(9%)など]に認められた。抗腫瘍効果は奏効率14.8%,病勢コントロール率66.7%であり,全生存期間および無増悪生存期間中央値はそれぞれ9.3か月,4.7か月であった。切除不能進行・再発胃癌に対するPTX+RAM療法は一定の効果が期待できるが,実地臨床においては高齢かつPSの悪い症例に対して使用することも多く,慎重なマネージメントが必要である。