Efficacy and Safety of Paclitaxel Plus Ramucirumab as Second-Line Therapy in Advanced Gastric Cancer: A Retro-Prospective Single-Centre Study.

Abstract

Background: Advanced gastric cancer (AGC) has limited treatment options beyond first-line therapy. The combination of paclitaxel and ramucirumab is an approved second-line regimen. This study evaluates the real-world efficacy and safety of this combination in Indian patients.

Aim: To assess the effectiveness and tolerability of paclitaxel plus ramucirumab in advanced gastric/gastroesophageal junction adenocarcinoma in a real-world setting.

Materials and methods: This retro-prospective study included 85 patients with AGC treated between January 2020 and December 2024 at a tertiary cancer centre in North India. Patients received paclitaxel 80 mg/m² on days 1, 8, and 15, and ramucirumab 8 mg/kg on days 1 and 15 of a 28-day cycle. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety.

Results: The median age was 58 years; 71% were male. ECOG PS 0-1 was present in 70%. Prior gastrectomy was reported in 36%. Median PFS was 5.1 months, and OS was 9.3 months. ORR was 27%, and DCR was 66%. Common grade 3/4 adverse events included neutropenia (19%), neuropathy (13%), and hypertension (9%).

Conclusion: Paclitaxel plus ramucirumab is effective and well-tolerated as second-line treatment in Indian AGC patients. Outcomes mirror global data and support its continued use in resource-limited settings.