Clinical Implication of Liver Metastasis in the Treatment of Gastric Cancer.

Abstract

The RAINBOW study is a phase 3 trial comparing the combination therapy of ramucirumab plus paclitaxel with paclitaxel monotherapy as palliative second-line treatment in patients with gastric or gastroesophageal junction adenocarcinoma [1]. A significant increase in both the median overall survival (OS, 9.6 vs 7.4 months) and progression-free survival (PFS, 4.4 vs. 2.9 months) was observed in patients who received ramucirumab plus paclitaxel. Based on this pivotal study, ramucirumab plus paclitaxel is the standard second-line treatment. The liver is one of the most common sites of metastasis of gastrointestinal cancer [2]. According to a study based on the Surveillance, Epidemiology, and End Results database, it is known that about 45% of metastatic gastric cancers are accompanied by liver metastasis (LM) [3]. In addition to peritoneal carcinomatosis, LM is an established poor prognostic factor of gastric cancer [4].