Ramucirumab plus paclitaxel prolongs survival in metastatic gastric/lower oesophageal cancer

Treatment with paclitaxel plus ramucirumab beyond the first-line setting appears to improve overall survival (OS) among patients with metastatic gastric or lower oesophageal adenocarcinoma, results of a real-world study have shown.

The authors performed a retrospective, registry-based study using datasets from Alberta Cancer Registry and other provincial databases in Alberta, Canada. They identified factors associated with palliative chemotherapy use using multivariable logistic regression analysis.

Kaplan-Meier survival estimates were used to compare outcomes among patients receiving more than one line of chemotherapy according to ramucirumab plus paclitaxel use. Factors associated with OS in this cohort were identified using Cox regression analysis.

Overall, 1,590 participants were analysed, including 1,070 gastric and 520 lower oesophageal patients. Factors associated with use of palliative chemotherapy were younger age (odds ratio [OR] with increasing age, 0.95, 95 percent confidence interval [CI], 0.94–0.95) and lower Charlson Comorbidity Index (OR with increasing index, 0.82, 95 percent CI, 0.74–0.91).

Among patients who received more than one line of chemotherapy, use of ramucirumab plus paclitaxel correlated with better OS (p=0.033).

In multivariable Cox regression analysis, improved OS was associated with use of ramucirumab plus paclitaxel (hazard ratio [HR], 1.56, 95 percent CI, 1.07–2.29) and living within urban zones including Calgary or Edmonton zone relative to the Northern zone (HR for Calgary vs Northern zone, 0.44, 95 percent CI, 0.23–0.85; HR for Edmonton vs Northern zone, 0.41, 95 percent CI, 0.22–0.77).

“Further work is needed to reduce disparity in our healthcare system between individuals living in rural vs urban areas,” the authors said.