Ramucirumab’s Gastric QoL Benefits Add To Survival Advantages

As well as improving survival, quality of life is maintained for longer in advanced gastric or gastro-oesophageal junction cancer patients given ramucirumab plus paclitaxel than placebo plus paclitaxel

medwireNews: RAINBOW trial results indicate that patient-reported quality of life (QoL) is improved by the addition of ramucirumab to paclitaxel for the treatment of advanced gastric or gastro-oesophageal junction adenocarcinoma.

Previously reported findings from the phase III study showed that patients treated with the vascular endothelial growth factor receptor 2 inhibitor plus paclitaxel achieved significantly better overall survival, progression-free survival and tumour response than those treated with placebo plus paclitaxel.

The current findings, published in the Annals of Oncology, now show that the 330 patients randomly assigned to receive the ramucirumab–paclitaxel combination after prior treatment with fluoropyrimidine and platinum achieved comparable or longer time to deterioration than those given placebo–paclitaxel on 14 of the 15 EORTC QoL questionnaire (QLQ-C30) functional, symptom and financial impact scales.

The only QoL outcome to favour placebo–paclitaxel was that measuring diarrhoea, say Salah-Eddin Al-Batran, from the Institute of Clinical Cancer Research in Frankfurt, Germany, and co-authors, prompting them to suggest that clinicians might proactively inform patients of symptom management options for this side effect.

Ramucirumab–paclitaxel was associated with a longer time to deterioration from a baseline performance status (PS) of 0/1 than placebo–paclitaxel. This was true when deterioration was defined as a PS of 2 or higher (hazard ratio [HR]=0.8) or 3 or higher (HR=0.7), and when defined as deterioration of at least 1 PS level (HR=0.8) or 2 PS levels (HR=0.6).

“Analysis of [time to deterioration] in PS corroborates that ramucirumab treatment maintains the health of patients for a longer period”, the authors write, adding: “The preservation of patients’ functional status is a key goal and may allow for them to receive further treatment and additional benefit.”

Salah-Eddin Al-Batran et al therefore conclude: “These results support the recommendation of paclitaxel+ramucirumab for previously treated gastric/[gastro-oesophageal junction] cancer if a taxane is indicated and if there are no ramucirumab contraindications.”

Reference

Al-Batran S-E, Van Cutsem E, Oh SC, et al. Quality-of-life and performance status results from the phase 3 RAINBOW study of ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated gastric or gastroesophageal junction adenocarcinoma. Ann Oncol 2016; Advance online publication 7 January. doi: 10.1093/annonc/mdv625

medwireNews (www.medwireNews.com) is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2016