演題抄録

一般口演

開催概要
開催回
第56回・2018年・横浜
 

Ramucirumabは胃癌患者の予後改善に貢献しているか?~当科の二次治療の検討から~

演題番号 : O28-5

[筆頭演者]
演者)金高 賢悟:1 
[共同演者]
小林 和真:1、小林 慎一朗:1、米田 晃:1、岡田 怜美:1、崎村 千香:1、久芳 さやか:1、小坂 太一郎:1、足立 智彦:1、虎島 泰洋:1、伊藤 信一郎:1、山之内 孝彰:1、池辺 絢:1、高槻 光寿:1、江口 晋:1

1:長崎大学・移植・消化器外科

 

Background: Based on the results of the REGARD and RAINBOW trials, Ramucirumab (Rmab) alone or combined with PTX is recognized as the standard second-line chemotherapy (CT) for ARGC. We explored the factors supporting second-line CT with a focus on the difference between pre- and post-Rmab. Methods: We retrospectively reviewed 36 ARGC patients who failed to sufficiently respond to first-line therapy between July 2008 and March 2018. Results: The patients were a mean 67.0 years old, with 22 males and 14 females. The patient status was unresectable (17), non-curative operation (3) and postoperative recurrence (16). Second-line regimens were taxanes (TA; 22, including Rmab+PTX), CPT-11 (IRI; 9), 5-FUs (3) and Rmab alone (1). The response rate was 16.7%. The median progression-free survival (PFS) and survival time since second-line CT were 97 and 285 days, respectively. The overall survival (OS) since first-line therapy significantly correlated with the PFS of first-line therapy (p<0.014), while the OS since second-line therapy (2nd OS) was independent of the PFS of first-line therapy. The 2nd OS did not correlate with the type of second-line CT, but the 2nd OS in patients receiving both TA and IRI was significantly longer than in those receiving either alone (p=0.0189). There was no significant difference in the PFS or 2nd OS between Rmab-containing regimens and other regimens. However, the OS since first-line treatment of post Rmab (all lines) was slightly, but significantly longer than the one before Rmab administration (p=0.0562). Conclusions: These findings suggest that adding second-or-higher-line CT may prolong the survival of ARGC patients, even when the anti-tumor effect is deemed insufficient following first-line therapy. Furthermore, the strategy of using all available agents in the treatment of ARGC might be necessary. Using Rmab-containing regimens might improve the prognosis of ARGC.

キーワード

臓器別:胃・十二指腸

手法別:化学療法

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