Ramucirumab–paclitaxel combo works better against HER2-positive vs -negative gastric cancers

Treatment with the combination of ramucirumab and paclitaxel in the second-line setting appears to yield higher responses among patients with HER2-positive gastric or gastro-oesophageal junction (GEJ) adenocarcinoma than among those with HER2-negative disease, according to a subgroup analysis of a nationwide, real-world study in Korea (KCSG-ST19-16).

The KCSG-ST19-16 study included a total of 1,063 patients with advanced gastric or GEJ adenocarcinoma who had received ramucirumab plus paclitaxel as a second-line treatment. Of these patients, 994 (93.5 percent) had known HER2 status and were included in the current subgroup analysis.

A total of 163 patients (16.4 percent) had HER2-positive gastric or GEJ adenocarcinoma. These patients had significantly higher objective response rate to ramucirumab plus paclitaxel treatment compared with those who had HER2-negative disease (23.0 percent, 95 percent confidence interval [CI], 15.9–30.1 vs 15.1 percent, 95 percent CI, 12.3–17.9; p=0.025).

Furthermore, the median progression-free survival was more favourable in the group of patients with HER2-positive vs HER2-negative disease, although the difference was not statistically significant (4.3 months, 95 percent CI, 3.7–5.3 vs 3.7 months, 95 percent CI, 3.4–4.0; p=0.054).

In terms of median overall survival, however, there was no clinically meaningful difference seen between the HER2-positive and HER2-negative groups (9.8 months, 95 percent CI, 8.9–12.3 vs 10.1 months, 95 percent CI, 9.2–10.9; p=0.564).