Ramucirumab in combination with paclitaxel in the second line of treatment for metastatic gastric cancer : retrospective analysis of the treatment experience at the Oncology and Radiotherapy Clinic, University Hospital of Split

Ciljevi: Primarni ciljevi diplomskog rada su ukupno preživljenje (OS) i preživljenje bez progresije bolesti (PFS) nakon terapije ramucirumabom u kombinaciji s paklitakselom u drugoj liniji liječenja metastatskog raka želudca. Ispitanici i postupci: Retrospektivno je analizirano 14 pacijenata s metastatskim rakom želudca koji su liječeni ramucirumabom u kombinaciji s paklitakselom na Klinici za onkologiju i radioterapiju KBC-a Split u razdoblju od 18.10.2018. do 14.5.2022. Rezultati: Rezultati ove retrospektivne studije pokazuju dobar učinak terapije ramucirumabom u kombinaciji s paklitakselom u drugoj liniji liječenja metastatskog raka želudca. Kada se usporede s rezultatima većih međunarodnih randomiziranih studija (RAINBOW) dobiju se gotovo identični rezultati. Medijan OS u RAINBOW studij iznosio je 9,6 mjeseci (raspon 8,5-10,8 mjeseci), u našoj studiji on je iznosio 9,4 mjeseca. Medijan PFS u RAINBOW studiji je iznosio 4,4 mjeseca (raspon 4,2-5,3 mjeseca), u našoj studiji on je iznosio 4 mjeseca (raspon 0.3-15.9 mjeseci). Kada se gleda broj i učestalost prijavljenih nuspojava također se ne nailazi na veća odstupanja u odnosu na RAINBOW studiju. Zaključci: Ramucirumab u kombinaciji s paklitakselom predstavlja dobar izbor u drugoj liniji liječenja metastatskog raka želudca. Pokazuje dobre rezultate glede produljenja OS-a i PFS-a i ima prihvatljiv profil toksičnosti.Objectives: The primary objectives of the thesis are overall survival (OS) and progression-free survival (PFS) after ramucirumab therapy in combination with paclitaxel in the second-line treatment of metastatic gastric cancer. Subjects and methods: 14 patients with metastatic gastric cancer were retrospectively analyzed. They were treated with ramucirumab in combination with paclitaxel at the Oncology and Radiotherapy Clinic, University Hospital of Split in the period from 18.10.2018 . to 14.5.2022. Results: The results of this retrospective study show a good effect of ramucirumab in combination with paclitaxel in the second-line treatment of metastatic gastric cancer. When compared with the results of larger international randomized studies (RAINBOW), almost identical results are obtained. Median OS in the RAINBOW study was 9.6 months (range 8.5-10.8 months), in our study it was 9.4 months. The median PFS in the RAINBOW study was 4.4 months (range 4.2-5.3 months), in our study it was 4 months (range 0.3-15.9 months). When looking at the number and frequency of reported side effects, there are also no major deviations compared to the RAINBOW study. Conclusions: Ramucirumab in combination with paclitaxel is a good choice in second-line treatment of metastatic gastric cancer. It shows good results regarding the prolongation of OS and PFS and has an acceptable toxicity profile