Division of Hematology and Oncology, Weill Cornell Medicine/New York Presbyterian Hospital , New York , NY , USA.
Expert Opin Biol Ther. 2019 Nov;19(11):1135-1141. doi: 10.1080/14712598.2019.1656715. Epub 2019 Aug 27.
: Gastric cancer remains one of the most lethal malignancy, accounting for an estimated 783,000 deaths worldwide in 2018. Although there are several approved drugs for the treatment of gastric cancer, the survival of patients with advanced disease remains dismal. Ramucirumab, a vascular endothelial growth factor receptor-2 inhibitor, is an important new targeted drug approved for gastric and gastroesophageal adenocarcinoma (GEJ) in second-line setting. : In this article, we have reviewed the role of ramucirumab in the management of gastric and GEJ adenocarcinoma. A comprehensive review of various clinical trials is presented that support the use of ramucirumab in gastric cancer. : In our opinion, ramucirumab should be considered as a standard of care option, either alone or with paclitaxel, after progression on first-line therapy for advanced or metastatic disease. The results of large, randomized phase III clinical trials show benefit of ramucirumab on median overall survival (OS). However, the benefit is limited, with only about two months OS benefit of using ramucirumab with paclitaxel compared to paclitaxel alone. Novel combination therapies, such as ramucirumab with other targeted agents and immune checkpoint inhibitors in ongoing clinical trials, may provide important information to further improve the patient outcomes.
胃癌仍然是最致命的恶性肿瘤之一，据估计 2018 年全球有 78.3 万人因此死亡。尽管有几种批准用于治疗胃癌的药物，但晚期患者的生存率仍然很低。雷莫芦单抗是一种血管内皮生长因子受体-2 抑制剂，是一种新的靶向药物，被批准用于二线治疗胃和胃食管腺癌（GEJ）。在本文中，我们回顾了雷莫芦单抗在胃腺癌和 GEJ 腺癌治疗中的作用。我们对支持雷莫芦单抗在胃癌中应用的各种临床试验进行了全面回顾。在我们看来，对于晚期或转移性疾病，在一线治疗进展后，雷莫芦单抗应单独使用或与紫杉醇联合使用，作为标准治疗方案。大型随机 III 期临床试验的结果表明，雷莫芦单抗可延长中位总生存期（OS）。然而，获益有限，与紫杉醇单药治疗相比，使用雷莫芦单抗联合紫杉醇仅能延长约两个月的 OS。正在进行的临床试验中的新型联合治疗，如雷莫芦单抗与其他靶向药物和免疫检查点抑制剂的联合治疗，可能会提供重要信息，以进一步改善患者的预后。
