Tim Brown, Adjunct Assistant Professor of Hematology-Oncology at Penn Medicine – Abramson Cancer Center, shared a post on X:
“Excited to share our recent work in American Journal of Clinical Oncology ‘A Real-World, Propensity-Matched Analysis of Second-Line FOLFIRI-Ramucirumab Versus Ramucirumab-Paclitaxel in Patients With Advanced Upper Gastrointestinal Cancers’.
Since 2014, ramucirumab-paclitaxel is the standard offering for 2L gastric cancer and has been extrapolated to esophageal cancer. However, taxane-based regimens risk worsening the neuropathy that can develop in 1L.
FOLFIRI with ramucirumab emerged as a potential option for 2L treatment based on this work by Sam Klempner which was subsequently cited by NCCN guidelines. This option potentially spares the neuropathy risk. Read more.
Yet it has only been compared head-to-head with ram-pac in a single trial I am aware of – the RAMIRIS study based out of Germany. Although negative, this trial demonstrated the feasibility of FOLFIRI-Ram as a viable 2L option. Read more.
In our work, we used the Flatiron Health database to identify patients with advanced upper GI cancers receiving second line FOLFIRI-Ram or Ram-Pac to compare outcomes. We used propensity score matching to account for measured confounders.
Ultimately, we find similar OS, but time to treatment discontinuation (surrogate for PFS) favored FOLFIRI-Ram in 2L. This will need to be confirmed in future prospective work, but this affirms FOLFIRI-Ram as a 2L option. Read more.
Title: A Real-World, Propensity-Matched Analysis of Second-Line FOLFIRI-Ramucirumab Versus Ramucirumab-Paclitaxel in Patients With Advanced Upper Gastrointestinal Cancers
Authors: Jonathan M. Hyak, Peifeng Ruan, Amy L. Jones, Nilesh Verma, Victoria Chung, Udhayvir S. Grewal, Deepak Vadehra, Nicholas Hornstein, Sam C. Wang, Matthew R. Porembka, Shahed Badiyan, Nina N. Sanford, Syed Kazmi, Timothy J. Brown
You can read the full article in American Journal of Clinical Oncology.
More posts featuring Tim Brown.