Analysis of prognostic factors for survival in the Russian population of patients with disseminated gastric cancer, who received ramucirumab as secondline therapy in the RAMSELGA trial

Медицинский совет

A. A. Tryakin¹  E. Yu. Ratner²  A. Yu. Povyshev³  R. V. Orlova⁴  G. M. Teletaeva⁴  N. P. Belyak⁵  D. M. Ponomarenko⁵  M. I. Andrievskikh⁶  A. S. Zhabina⁷  D. Yu. Yukalchuk⁸  E. V. Perminova⁸  Е. V. Artamonova⁹  T. A. Titova⁹  S. V. Gamayunov⁹  N. S. Besova⁹  D. L. Stroyakovskiy⁹  A. V. Smolin^1,10  A. S. Mochalova^1,10  I. S. Stilidi^1,11  O. O. Gordeeva^1,12 

[1] Pirogov Russian National Research Medical University;St Petersburg University;A.F. Tsyb Medical Radiological Research Centre;City Clinical Oncology Centre;Irkutsk Regional Cancer Centre;Main Military Clinical Hospital named after Academician N.N. Burdenko;Medsi Group;Moscow City Oncology Hospital No. 62;N.N. Blokhin National Medical Research Center of Oncology;Petrov National Medical Cancer Research Centre;Regional Clinical Hospital;Republican Oncological Clinical Dispensary of the Ministry of Health of the Republic of Tatarstan;

关键词: gastric cancer;    second line;    ramucirumab;    prognostic factors;    paclitaxel;    irinotecan;   

DOI  :  10.21518/2079-701X-2020-9-165-174

来源: DOAJ

【 摘 要 】

Background. Ramucirumab is a monoclonal antibody that inhibits the vascular endothelial growth factor receptor-2 (VEGFR2). The study is aimed to analyse prognostic factors for survival in patients with disseminated gastric cancer who received ramucirumab in the second-line therapy in ’real-life’ clinical setting of Russia (RAMSELGA). Methods. We retrospectively analysed the outcome of 163 patients aged 20–78 years from 11 oncological centres in Russia. Survival analysis was performed using the Kaplan – Meier model, and regression analysis was performed using the Cox model. Results. In a univariate analysis of overall survival, 5 factors were identified as independent factors of an unfavourable prognosis: 1) age <65 years (RR 0.542; 95% CI 0.302–0.971; p = 0.039); 2) time to tumour progression on the first-line therapy is not more than four months. (RR 0.161; 95% CI 0.105–0.246; p = 0.0000); 3) a low grade tumour or colloid cancer (RR 1,868; 95% CI 1,063–3,284; p = 0,030); 4) peritoneal metastasis (RR 1.549; 95% CI 1.026–2.339; p = 0.037); 5) ascites or pleurisy (RR 0.624; 95% CI 0.424–0.920; p = 0.017). In a multivariate analysis, favourable prognostic factors of overall survival of patients included age – 65 years or older (OS 2.288; 95% CI 1.240–4.220; p = 0.008) and time to tumour progression on the first-line therapy – more than 4 months (OS 6.650; 95% CI 4.221–10.477; p = 0.000). Conclusion. Despite an active search, prognostic factors for survival in patients that are universal for dGC have not yet been found. To build a universal prognostic model, a very thoughtful analysis considering not only clinical and laboratory, but also pathomorphological and molecular genetic characteristics is required.

【 授权许可】

Unknown