Ramucirumab in patients with advanced gastric and gastroesophageal junction cancer: Learnings from East Asian data

Advanced gastric and gastroesophageal junction cancers remain a major cause of concern considering their high incidence in Taiwan, poor outcomes essentially due to diagnosis at the advanced stage, and poor prognosis. These evidences along with the heterogeneity associated with the disease reflect that there is a requirement of new and robust active treatment options for advanced gastric and gastroesophageal junction cancers. Because tumor angiogenesis plays a key role in the pathogenesis and progression of these cancers, recent studies indicate that anti-angiogenesis is a promising approach for the treatment of the disease. The recent phase III trials REGARD and RAINBOW showed survival benefits (improved median overall and progression-free survival) and acceptable safety profiles with ramucirumab alone and ramucirumab plus paclitaxel, respectively in patients with disease progression on or after first-line chemotherapy. Further, these data unveil that ramucirumab plus paclitaxel could be regarded as a new standard second-line treatment for patients with advanced or metastatic gastric or gastroesophageal junction cancers in Taiwan.