Efficacy and safety of ramucirumab in gastric or gastroesophageal cancer: A systematic review and meta-analysis - 21/09/24

Highlights |
• | Ramucirumab: prolongs OS, PFS, ORR and DCR. |
• | Ramucirumab: higher incidence of hypertension, bleeding and diarrhea. |
• | Age, treatment line impact efficacy: ≥60, 2nd line benefit more. |
• | Study based on latest trials, offers crucial clinical guidance. |
Abstract |
Background |
Ramucirumab is considered a potential treatment for gastric or gastroesophageal cancer; however, its safety has not been evaluated. This meta-analysis aimed to evaluate the efficacy and safety of ramucirumab for treating gastric or gastroesophageal cancer.
Methods |
The databases of PubMed, Embase, and Cochrane Library were searched through October 2023. The search focused on randomized controlled trials (RCTs) comparing ramucirumab (with or without chemotherapy) to a placebo (with or without chemotherapy) in patients with gastric or gastroesophageal cancer. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were pooled.
Results |
Seven RCTs with a total of 2613 patients were included. Compared with placebo (with or without chemotherapy), ramucirumab (with or without chemotherapy) significantly improved OS (HR: 0.90, 95% CI: 0.82–0.99, p = 0.030), PFS (HR: 0.74, 95% CI: 0.60–0.90, p = 0.003), ORR (OR: 1.39, 95% CI: 1.15–1.67, p < 0.001), and DCR (OR: 1.91, 95% CI: 1.38–2.63, p < 0.001). However, ramucirumab (with or without chemotherapy) also increased the incidence of decreased appetite (OR: 1.29, 95% CI: 1.09–1.53, p = 0.004), diarrhea (OR: 1.39, 95% CI: 1.01–1.91, p = 0.05), hypertension (OR: 3.13, 95% CI: 2.03–4.83, p < 0.00001), and bleeding or hemorrhage (OR: 2.34, 95% CI: 1.93–2.85, p < 0.00001).
Conclusions |
Ramucirumab (with or without chemotherapy) can improve OS, PFS, ORR and DCR in patients with gastric or gastroesophageal cancer. However, it may also increase the incidence of specific AEs.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Ramucirumab, Stomach neoplasms, Gastroesophageal neoplasms, Chemotherapy, Meta-analysis
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Vol 48 - N° 8
Articolo 102466- Ottobre 2024 Ritorno al numeroBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
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