Rutika Mehta, MD, MPH, gastrointestinal medical oncologist, Moffitt Cancer Center, discusses recent progress that has been made in advanced gastric cancer.
The field of gastric cancer is progressing at a rapid pace, and immuno-oncology is taking precedence in the field, says Mehta. Several novel combinations are under investigation. Patients have more first-, second-, and now, third-line options than ever before. The field is no longer dependent on the use of chemotherapy alone; rather, targeted treatments and immunotherapeutic agents have taken over the space.
Ramucirumab (Cyramza) is one such agent that, based on data from the phase III RAINBOW and REGARD trials, is FDA approved for use either alone or in combination with paclitaxel in the second-line setting. Notably, most patients with advanced disease will receive a fluoropyrimidine with a platinum-based agent in the frontline setting. This can cause neuropathy over time, which may be exacerbated by the combination of ramucirumab and paclitaxel in the second-line setting, cautions Mehta.
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