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開催概要
開催回
第56回・2018年・横浜
 

切除不能・再発胃癌に対する weekly nab-paclitaxel + ramucirumab による2次化学療法

演題番号 : O28-2

[筆頭演者]
演者)吉野 茂文:1,2 
[共同演者]
武田 茂:2、飯田 道久:2、兼清 信介:2、西山 光郎:2、鈴木 伸明:2、吉田 晋:2、友近 忍:2、徳光 幸生:2、前田 訓子:2、山本 滋:2、硲 彰一:3、上野 富雄:4、永野 浩昭:2

1:山口大学附属病院・腫瘍センター、2:山口大学・消化器・腫瘍外科、3:山口大学・先端がん治療開発学、4:川崎医科大学・消化器外科

 

Background. The ABSOLUTE trial showed that weekly nab-paclitaxel (PTX) was non-inferior to weekly PTX, and the RAINBOW trial demonstrated that the combination of ramucirumab (RAM) with PTX significantly increased OS compared to PTX alone. Therefore, weekly nab-PTX plus RAM combination therapy could provide new treatment option in patients with advanced gastric cancer as a second-line chemotherapy.
Patients and Methods. Seven patients refractory to first-line chemotherapy were treated with weekly nab-PTX plus RAM. Patients received nab-PTX at a starting dose of 80-100 mg/m2 on days 1, 8 and 15, and RAM at a dose of 8 mg/kg on days 1 and 15 every 4 weeks until disease progression or the appearance of unacceptable toxicity.
Results. In 7 patients, the median age was 55 years (47-73 years), with 5 males and 2 females. Two patients received nab-PTX at a starting dose of 100 mg/m2, however the dose was reduced to 80 mg/m2 in both patients due to grade 3 neutropenia and grade 2 fatigue. Five patients received at a starting dose of 80 mg/m2 and the dose was reduced to 60 mg/m2 in two patients due to grade 3 neutropenia. All grades neutropenia developed in all patients, and grade 2 and 3 neutropenia developed in 1 and 4 patients, respectively. As a non-hematologic adverse events, grade 2 fatigue developed in 2 patients. The median TTF was 5.1 months and the median PFS was same as the median TTF. The median OS did not reach yet. Four patients who had measurable lesions according to RECIST showed PR in 2, SD in 1 and PD in 1. As a clinical evaluation, six patients who had evaluable lesions showed PR in 2, SD in 3 and PD in 1.
Conclusion. In weekly nab-PTX plus RAM combination therapy, some patients were obligated to reduce the dose of nab-PTX to 60-80 mg/m2 due to grade 3 neutropenia. However, this combination therapy showed promising activity and manageable toxicities and could be a useful second-line treatment option in patients with unresectable or recurrent gastric cancer.

キーワード

臓器別:胃・十二指腸

手法別:化学療法

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