FOLFIRI-ramucirumab shows promise as second-line therapy in advanced UGI cancers

Combination therapy with FOLFIRI-ramucirumab exhibits survival advantage similar to ramucirumab plus paclitaxel in patients with advanced upper gastrointestinal (UGI) cancers, reveals a study. However, FOLFIRI-ramucirumab is associated with a longer real-world time to treatment discontinuation (rwTTD).

The authors probed the deidentified Flatiron Health Research Database for patients treated for unresectable or metastatic UGI with second-line ramucirumab-paclitaxel or FOLFIRI-ramucirumab from January 2011 to June 2024.

Study cohorts were propensity score matched 1:6 from key clinical and laboratory characteristics. OS and rwTTD were the primary endpoints.

A total of 15,908 patients with UGI cancer were identified. Of these, 631 received second-line ramucirumab-paclitaxel and 40 received second-line FOLFIRI-ramucirumab. Forty FOLFIRI-ramucirumab and 240 ramucirumab-paclitaxel patients were included in the analysis after matching.

The median OS was 9.7 months (95 percent confidence interval [CI], 6.9‒12.3) with FOLFIRI-ramucirumab and 7.7 months (95 percent CI, 6.2‒8.8) with ramucirumab-paclitaxel, with a 26-percent reduced risk of mortality with FOLFIRI-ramucirumab (HR, 0.74, 95 percent CI, 0.50‒1.11; p=0.14).

Furthermore, the FOLFIRI-ramucirumab arm had a median rwTTD of 5.2 months (95 percent CI, 4.1‒6.2) compared with 3.7 months (95 percent CI, 3.2‒4.3) with ramucirumab-paclitaxel (HR for treatment discontinuation, 0.70, 95 percent CI, 0.48‒1.00; p=0.048).

“Altogether, these data suggest FOLFIRI-ramucirumab is a potential alternative for second-line treatment of UGI cancers,” the authors said.