Clinical prognosis factor of ramucirumab monotherapy for advanced gastric cancer

Background: The REGARD trial resulted in insurance approval for ramucirumab monotherapy, but it did not include Japanese patients. Since then, phase II trials and retrospective studies in Japanese patients have been published, but there have been few reports on prognostic factors. Methods : A total of 27 patients received ramucirumab monotherapy as a second-line treatment for gastric cancer at six institutions from September 2017 to December 2019. Results: The response rate was 3.7%, the disease control rate was 18.5%, the median progression-free survival time was 2.1 months, and the median survival time was 3.0 months. Six of the 27 patients received a 3rd line therapy, while 4 received nivolumab alone. Overall survival did not differ significantly between patients who received third-line treatment and those who did not. Survival curves showed no significant differences based on tumor markers (CEA and CA19-9), age, histology, lung metastasis, lymph node metastasis, or peritoneal metastasis; however, liver metastasis was a poor prognostic factor. Conclusions: Ramucirumab monotherapy was linked to a poor prognosis in older patients with gastric cancer who had a poor performance status, with liver metastasis being suggested as a poor prognostic factor.