Weight loss and body mass index in advanced gastric cancer patients treated with second-line ramucirumab: a real-life multicentre study

Alessandro Parisi, Alessio Cortellini, Michela Roberto, Olga Venditti, Daniele Santini, Emanuela Dell’Aquila, Marco Stellato, Paolo Marchetti, Mario Alberto Occhipinti, Federica Zoratto, Federica Mazzuca, Nicola Tinari, Michele De Tursi, Laura Iezzi, Clara Natoli, Margherita Ratti, Claudio Pizzo, Michele Ghidini, Giampiero Porzio, Corrado FicorellaKatia Cannita

Research output: Contribution to journalArticlepeer-review

Abstract

Aims and methods: This multicenter retrospective study aims to evaluate the correlations between Body Weight Loss (BWL), Body Mass Index (BMI) and clinical outcomes (ORR, PFS, and OS) of advanced gastric cancer (aGC) patients treated with second-line ramucirumab-based therapy in a “real-life” setting. Results: From December 2014 to October 2018, 101 consecutive aGC patients progressed to a first-line chemotherapy were treated with ramucirumab alone (10.9%) or in combination with paclitaxel (89.1%). Median BMI was 21.2 kg/m2 and mBWL since first-line treatment commencement was 4.5%. Among 53 patients who underwent primary tumor resection (PTR), 73.6% experienced BWL, while 26.4% did not experience BWL (p = 0.0429). Patients who underwent PTR had a significantly higher probability of experiencing BWL (yes vs no) [OR = 2.35 (95% CI 1.02–5.42), p = 0.0439]. Among the 89 evaluable patients, ORR was 26.9% (95% CI 17.2–40.1). At a median follow-up of 17.3 months, mPFS was 5.4 months (95% CI 3.6–6.8) and mOS was 8.7 months (95% CI 7.3–11.9). In the multivariate analysis, only ECOG-PS and BMI were confirmed independent predictors for shorter PFS [HR = 1.69 (95% CI 1.01–2.82), p = 0.04] [HR = 1.97 (95% CI 1.12–3.46), p = 0.01] and OS [HR = 1.69 (95% CI 1.01–2.83), p = 0.04] [HR = 2.08 (95% CI 1.17–3.70), p = 0.01]. Conclusion: Efficacy of ramucirumab is confirmed in this “real-life” analysis. BWL seems not to have correlations with clinical outcomes in these patients, while BMI and ECOG-PS remain major prognostic factors. A possible explanation for the lack of prognostic effect of BWL might be the proportion of patients subjected to PTR in this series (52.5%).

Original languageEnglish
Pages (from-to)2365-2373
JournalJournal of Cancer Research and Clinical Oncology
Volume145
Issue number9
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • Advanced gastric cancer
  • Body mass index
  • Body weight loss
  • Prognostic factors
  • Ramucirumab
  • Second-line chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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