催眠药
福尔菲里
医学
多西紫杉醇
内科学
临床终点
转移性乳腺癌
危险系数
人口
临床研究阶段
紫杉醇
肿瘤科
化疗
胃肠病学
外科
癌症
置信区间
随机对照试验
乳腺癌
伊立替康
结直肠癌
环境卫生
作者
Sylvie Lorenzen,Peter Thuss‐Patience,Claudia Pauligk,Eray Gökkurt,Thomas Jens Ettrich,Florian Lordick,Michael Stahl,Peter Reichardt,Martin Sökler,Daniel Pink,Stefan Probst,Axel Hinke,Thorsten Oliver Goetze,S. Al-Batran
标识
DOI:10.1016/j.ejca.2022.01.015
摘要
Ramucirumab and paclitaxel is the standard second-line therapy in patients with metastatic gastroesophageal adenocarcinoma. We report the efficacy and safety analyses of FOLFIRI and ramucirumab versus paclitaxel and ramucirumab after the failure of a platinum- and fluoropyrimidine-containing chemotherapy.This multicenter, investigator initiated, phase II trial randomised patients with gastroesophageal adenocarcinoma to either FOLFIRI plus ramucirumab (RAM) (arm A) or paclitaxel plus RAM (arm B). The primary end-point was 6-month overall survival (OS) rate, with a proportion of ≥65% in arm A considered a positive signal for further investigation.111 patients (65% of patients had prior docetaxel) were enrolled and 110 patients qualified for ITT population (arm A, 72; arm B, 38). The study did not meet the primary end-point for the comparison with historical control, as 6-month OS rate in the FOLFIRI plus RAM arm was 54% (95% CI 44-67). In between arm comparison, OS was similar (hazard ratio, HR 0.97 [95% CI 0.62-1.52]), while objective response rates (ORRs) and PFS were numerically better in arm A versus arm B (HR for PFS 0.73; ORR, 22% versus 11%). These differences were largely attributed to favourable efficacy results for arm A in docetaxel-pretreated patients (HR, 0.49; ORR, 25% versus 8%). In the safety population (n = 106), grade 3-5 adverse events were similar between arms (arm A, 75%; arm B, 68%).The RAMIRIS trial demonstrated feasibility of FOLFIRI plus RAM. While the study was formally negative, it provided a signal to further investigate this combination for the group of patients with previous docetaxel therapy.clinicaltrials.gov identifier: NCT03081143.
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