Akademik Veri Yönetim Sistemi
Annals of Medical Research, cilt.2026, sa.33, ss.91-98, 2026 (TRDizin)
Aim:This study primarily aimed to assess the efficacy of second-line ramucirumab (RAM) pluspaclitaxel (PTX) in patients with advanced gastric and gastroesophageal junction (GEJ) cancersand to compare its outcomes with those of RAM+PTX plus immune checkpoint inhibitor (ICI) inreal-world practice. The secondary objective was to assess the safety of RAM+PTX (±ICI) andto explore its efficacy in later-line settings.MaterialsandMethods:This single-center study retrospectively analyzed the clinicopathologicdata of patients with advanced gastric/GEJ cancer treated with RAM+PTX, with or without anICI, in second-line or later settings between January 2018 and September 2024. Efficacy wasevaluated based on the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). We analyzed efficacy outcomes by treatment line.Results:We identified 46 patients (female, 54.3%) who received RAM+PTX (±ICI). In the second-line setting, 27 patients (58.7%) received RAM+PTX, and 10 patients (21.7%) received RAM+PTXplus nivolumab. The ORRs were 18.5% and 30.0% (p=0.66), and the DCRs were 55.6% and 80%(p=0.26), respectively. The addition of nivolumab did not significantly improve survival out-comes (median PFS, 4.3 vs. 3.1 months; HR, 0.93; 95% CI, 0.44-1.98; p=0.85; median OS, 7.8 vs.9.6 months; HR, 0.82; 95% CI, 0.35-1.91; p=0.64). Age≥50 years (HR, 2.90; 95% CI, 1.24-6.78;p=0.014) and the presence of ascites (HR, 2.86; 95% CI, 1.14-7.16; p=0.025) were independently
Aim: This study primarily aimed to assess the efficacy of second-line ramucirumab (RAM) plus
paclitaxel (PTX) in patients with advanced gastric and gastroesophageal junction (GEJ) cancers
and to compare its outcomes with those of RAM+PTX plus immune checkpoint inhibitor (ICI) in
real-world practice. The secondary objective was to assess the safety of RAM+PTX (±ICI) and
to explore its efficacy in later-line settings.
Materials and Methods: This single-center study retrospectively analyzed the clinicopathologic
data of patients with advanced gastric/GEJ cancer treated with RAM+PTX, with or without an
ICI, in second-line or later settings between January 2018 and September 2024. Efficacy was
evaluated based on the objective response rate (ORR), disease control rate (DCR), progression-
free survival (PFS), and overall survival (OS). We analyzed efficacy outcomes by treatment line.
Results: We identified 46 patients (female, 54.3%) who received RAM+PTX (±ICI). In the second-
line setting, 27 patients (58.7%) received RAM+PTX, and 10 patients (21.7%) received RAM+PTX
plus nivolumab. The ORRs were 18.5% and 30.0% (p=0.66), and the DCRs were 55.6% and 80%
(p=0.26), respectively. The addition of nivolumab did not significantly improve survival out-
comes (median PFS, 4.3 vs. 3.1 months; HR, 0.93; 95% CI, 0.44-1.98; p=0.85; median OS, 7.8 vs.
9.6 months; HR, 0.82; 95% CI, 0.35-1.91; p=0.64). Age ≥50 years (HR, 2.90; 95% CI, 1.24-6.78;
p=0.014) and the presence of ascites (HR, 2.86; 95% CI, 1.14-7.16; p=0.025) were independently
associated with poorer OS.
Conclusion: The real-world efficacy of RAM+PTX as second-line therapy in advanced gas-
tric/GEJ cancers is consistent with the results of randomized trials, though grade ≥3 adverse
events were more frequent. While adding nivolumab did not confer a statistically significant
benefit, a numerical improvement in ORR and DCR indicates potential value that warrants fur-
ther prospective evaluation.
3 adverseevents were more frequent. While adding nivolumab did not confer a statistically significantbenefit, a numerical improvement in ORR and DCR indicates potential value that warrants fur-ther prospective evaluation