Abstract 214P
Background
No standard second-line chemotherapy (CTx) for gastric (G-) and colorectal (C-) neuroendocrine carcinoma (NEC) has been established yet, and various regimens are used considering the guideline for adenocarcinoma of each organ or small cell lung cancer. Since a few reports with a small number of patients (pts) suggested that ramucirumab (RAM) may be effective in G-NEC, we investigated it adding C-NEC in this multicenter study.
Methods
We retrospectively collected the data of G- and C-NEC pts who received second-line CTx after platinum-based CTx from March 2015 to June 2020. The pathological diagnosis of NEC was re-confirmed centrally according to the WHO 2019 classification. We compared clinical outcomes between the pts with RAM (RAM group) and without RAM (Non-RAM group).
Results
Of 125 pts treated as NEC in the local centers, 100 pts diagnosed as NEC by the central pathological review were studied. The RAM and Non-RAM groups included 44 (G/C, 34/10 pts) and 56 (G/C, 37/19 pts) pts, respectively. In RAM/Non-RAM group, median age was 70/68 years and ECOG PS 1–2 was 55%/61%. In the RAM group, 68% of pts received RAM as second-line CTx. RAM was often combined with weekly paclitaxel in G-NEC (65%) and FOLFIRI in C-NEC (70%). In the Non-RAM group, 65% of G-NEC pts and 53% of C-NEC pts received amrubicin as second-line CTx. The median overall survival (OS) and progression-free survival (PFS) in the RAM group were 9.0 and 4.3 months from the initiation of RAM-containing CTx and those in the Non-RAM group were 5.6 and 1.8 months from the initiation of second-line CTx, respectively. The hazard ratios (HRs), calculated by inverse probability weighting method using propensity score, were 0.75 (95% CI 0.45–1.28) for OS and 0.45 (95% CI 0.27–0.75) for PFS. The RAM group showed significantly higher overall response rate than the Non-RAM group (44% vs. 6%, p < 0.001). G-NEC pts of the RAM group showed more favorable trends both in OS (HR 0.56, 95% CI: 0.29–1.09) and PFS (HR 0.32, 95% CI: 0.16–0.62).
Conclusions
RAM-containing CTx after platinum-based CTx may be effective for gastrointestinal NEC, especially G-NEC.
Clinical trial identification
UMIN000043200.
Editorial acknowledgement
Enago for the English language review.
Legal entity responsible for the study
West Japan Oncology Group.
Funding
Eli Lilly Japan K.K.
Disclosure
Y. Matsubara: Financial Interests, Personal, Invited Speaker: Takeda, Taiho, MSD, Eli Lilly Japan K.K. T. Masuishi: Financial Interests, Personal, Invited Speaker: Takeda, Chugai, Merck Bio Pharma, Taiho, Bayer, Eli Lilly, Yakult Honsha, Sanofi, Daiichi Sankyo, Ono, Bristol Myers Squibb, MSD, Nippon Kayaku; Financial Interests, Institutional, Funding: Daiichi Sankyo, Ono, Novartis, Amgen, Syneos Healthe Clinical, Boehringer-Ingelheim, Pfizer, Cimic Shift Zero, Eli Lilly. H. Hirano: Financial Interests, Personal, Invited Speaker: Taiho Pharmaceutical, Ono Pharmaceutical, Teijin Phama, Nichi-Iko, Novartis; Financial Interests, Institutional, Research Grant: Chugai Pharmaceutical, Daiichi Sankyo, Taiho Pharmaceutical, Ono Pharmaceutical, Janssen Pharmaceutical, Merck Biopharma, Bristol Myers Squibb, Pfizer, Eisai, Amgen, Astellas, Seagen, MSD, Insyte, BeiGene, Novartis. M. Furuta: Financial Interests, Personal, Invited Speaker: Eli Lilly, Bristol Myers Squibb, Merck & Co., Inc., ONO Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. K. Minashi: Financial Interests, Institutional, Research Grant: Astellas, Taiho Pharma, Amgen, Daiichi Sankyo Pharma., MSD, PPD-SNBL K.K. M. Komoda: Financial Interests, Personal, Invited Speaker: Lilly Japan, Ono Pharmaceutical, Bristol Myers Squibb Japan, Eisai, Daiichi Sankyo, Taiho Pharmaceutical, Chugai Pharma, MSD. K. Muro: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Ono, Chugai; Financial Interests, Personal, Invited Speaker: Eli Lilly, Ono, Daiichi Sankyo, Taiho, Bristol Myers Squibb, Takeda, Chugai, AstraZeneca, Amgen; Financial Interests, Institutional, Research Grant, Including local PI as role: Astellas, Amgen, Sanofi, Daiichi Sankyo, Taiho, MSD, Pfizer, Merck Biopharma, Eisai, Ono, Novartis; Non-Financial Interests, Principal Investigator: Takeda. All other authors have declared no conflicts of interest.