Dr. Davis on the Role of Ramucirumab in Gastric/GEJ Cancer

S. Lindsey Davis, MD, an assistant professor of medicine and gastrointestinal medical oncologist at the University of Colorado Cancer Center, discusses the role of ramucirumab (Cyramza) in the treatment of patients with gastric/gastroesophageal junction (GEJ) adenocarcinoma.

Data from the phase III RAINFALL trial presented at the 2018 Gastrointestinal Cancers Symposium showed that the addition of ramucirumab to standard first-line chemotherapy did not improve overall survival (OS), which served as the secondary endpoint of the study. The agent was initially FDA-approved for use in combination with paclitaxel as second-line therapy, based on data from the RAINBOW trial. Since the single agent had previously shown potent activity in heavily pretreated patients, it was thought that earlier exposure may lead to higher responses.

However, RAINFALL demonstrated that adding ramucirumab in the first-line setting does not confer an advantage in progression-free survival or OS. Accordingly, ramucirumab should only be used in the second-line setting, concludes Davis.