Ramucirumab extends survival for advanced colorectal cancer patients

14 Jan 2015

New findings from an international phase 3 study indicate that a combination of the targeted drug ramucirumab and FOLFIRI chemotherapy provides a survival advantage over the standard chemotherapy regimen for colorectal cancer with FOLFIRI (folinic acid, fluoruracil, and irinotecan) alone. Ramucirumab belongs to a class of drugs known as angiogenesis inhibitors and it works by blocking the growth of new blood vessels to the tumor, essentially starving it of nutrients.

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Sample from 1,000 patients

1,072 patients with advanced colorectal cancer whose disease progressed on or after initial therapy with bevacizumab and chemotherapy (consisting of oxaliplatin plus a fluoropyrimidine) were equally separated into 2 groups and randomly assigned to treatment with FOLFIRI plus ramucirumab or FOLFIRI plus placebo.

Although tumor shrinkage rates were similar in the two treatment groups (13.4% in the ramucirumab group vs. 12.5% in the placebo group), ramucirumab led to improvement in both progression-free and overall survival.

The improvement was small in absolute terms, but statistically significant. In particular:

  • The median time to disease progression in the ramucirumab group was 5.7 months compared with 4.5 months in the placebo group.
  • The median overall survival was 13.3 months in the ramucirumab group compared with 11.7 months in the placebo group.

Real-world applicable findings

“Advanced colorectal cancer is an incurable disease, particularly difficult to treat after initial therapy stops working. Our study also included patients with fast-growing tumors, so the findings are relevant to patients that we typically encounter in practice. It is very encouraging that we now have another safe option that adds benefit to standard chemotherapy in this second-line setting” said lead study author Josep Tabernero, MD, director of the Vall d’Hebron Institute of Oncology in Barcelona, Spain.

The findings provide proof-of-concept for the development of new second-line treatment strategies for advanced colorectal cancer, especially using a combination of an anti-angiogenic drug with standard chemotherapy in those whose disease progresses after first-line chemotherapy with bevacizumab.

Potential of ramucirumab to be researched

Dr Tabernero stated that while this study clearly shows that ramucirumab adds benefit to FOLFIRI chemotherapy, the findings should not be extrapolated to other chemotherapy regimens and schedules without formal investigation in clinical trials. Further research is also needed to explore potential benefits of ramucirumab. The agent is currently FDA approved only for the treatment of stomach cancer, but it is being studied in a range of other cancers.

 

Source: eCancer News

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